Electronic Health Information and EHRs: What Lies Ahead in 2017

As we near the end of January, I’d like to take the opportunity to look ahead and consider what the potential “hot topics” in health information management (HIM) might be for 2017. Naturally, electronic health information (EHI) and electronic health records (EHR) will continue as topics of discussion for the industry in the coming year.

Increasing Volumes and Varieties of Electronic Health Information

HIM professionals can expect to be inundated with increasing volumes and varieties of EHI from various sources, such as patients, colleagues the organization, and third parties.

This incoming EHI will have to be evaluated for, among other things, veracity and security. Decisions will have to be made about whether particular EHI should be categorized and stored as a part of the EHR. Thinking specifically about the potential duty to preserve the EHI for regulatory investigations or litigation, questions should be raised about audit trails and reasonable steps that should be taken to avoid the inadvertent or intentional loss of specific EHI. My previous posts “A Legal Perspective on the Importance of Effective Information Governance” and “A Primer for Avoiding Sanctions for the Loss of Electronically Stored Information” offer further discussion on these topics. I also addressed some of these concerns in my presentation at last year’s AHIMA Convention and Exhibit, “Integrating a New Technology into an Existing EHR Framework Using IG Principles.”

Continued Threat and Occurrence of Data Breaches

HIM professionals can also expect continued threat and occurrence of data breaches. These will result from particular healthcare providers being targeted by malicious “outsiders” as well as employees and third party business associates who fail to take adequate security measures. For a summary of 2016 data breaches, see Marla Durben Hirsch’s article in FierceHealthcare, “2016 A Banner Year for EHR Security Breaches.”

Unfortunately, data breaches must be anticipated and procedures should be in place to deal with the implications thereof, considering the almost-certainty of investigations at the federal and/or state level and possible litigation in the form of a class action. Healthcare providers should consider having a “game book” of sorts that can be referred to in the event of a breach to guide employees through next steps such as reporting the breach to regulators and patients, among other things. See the “Guide for Cybersecurity Event Recovery” from the National Institute of Standards and Technology for an example.

Patient Doubts on Health Data

HIM professionals should also be prepared for tension between healthcare professionals and patients, as well as possible skepticism from patients about the value of EHI. One survey, reported in FierceHealthcare, suggests that:

[t]he vast majority of physicians say healthcare data is overwhelming, redundant and doesn’t make a difference in care quality. But most patients say that their primary care physician’s office should store ant personal health information they ask them to.

In addition:

[m]ore than 50% of consumers are skeptical about the benefits of healthcare information technologies, including patient portals, mobile apps and electronic health records. And fully 70% of Americans distrust health technology, up sharply from just 10% in 2014.

These survey results may demonstrate weariness on the part of both healthcare professionals and patients and be a consequence of the profusion of electronic products that are currently—and soon-to-be—available. Whatever the cause or consequence, EHI volumes and varieties will increase and will have to be dealt with by HIM personnel and those personnel may wind up in unpleasant conversations at both ends of healthcare. And unpleasant conversations accompanied by “bad” outcomes may lead to litigation.

Of course, these are just predictions, and only time will tell what 2017 has in store.

More Reading

See the publication “2016 Report to Congress on Health IT Progress: Examining the HITECH Era and the Future of Health IT” from the Office of the National Coordinator for Health IT for examples of how the health IT landscape has evolved.

**Editor’s note: The views expressed in this column are those of the author alone and should not be interpreted otherwise or as advice.

Ron Hedges, JD, is a former US Magistrate Judge in the District of New Jersey and is a writer, lecturer, and consultant on topics related to electronic information. He is a Senior Counsel with Dentons US LLC. 

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