Connect Media and Philips recently hosted a diverse contingent of clinical, security and information executives – spanning the private and public health spectrum – to interrogate the transformative power of EMR in Victoria.

The sheer pace of technological discovery is triggering seismic change in nearly every industry, and healthcare is no exception. Pressure is mounting on leaders across the public and private divide to innovate and deliver seamless services to citizens in a digital landscape.

EMR embodies a fundamental technological shift, a bedrock of interoperability that can be built on for years to come. But entrenched barriers around cultural uptake, public scepticism of digital records, and corporate security, risk and reputational threats all emerged as shared pain points around implementing EMR solutions.

However, these concerns did not mute enthusiasm for the potential of EMR to radically improve patient outcomes and transform healthcare as we know it. This paper provides an inside look at the key hurdles on the EMR journey, and ultimately, why the race is worth running.

‘There is a treasure trove of data that nobody seems to have the keys to open.’

There is immense and unrealised potential in patient health data. Many in attendance lamented their current incapacity to direct the swathes of data they are collecting towards any discernible patient-led outcome. Many noted that My Health Record assaulted clinicians with too much unstructured information, and in doing so, compromised a core selling point of the system – buying clinicians time.

Looking forward, and with cognitive computing and artificial intelligence beginning to mature in all sectors of the national economy, there is hope that the patient data embedded in EMR can be leveraged to drive real change. In recognition of the road that lies ahead, there was a consensus that extended efforts must be made now to protect the integrity of data assets.

Particularly, the room was wary of the unconscious biases that are likely burrowing into digital records, which could compromise the integrity of the system at large once a critical mass is reached. A further note of concern was the agility, or lack thereof, of integrated solutions to respond and adapt at pace – data must be used to drive change continuously, on a daily or weekly basis, not on a two-yearly basis.

Concerning the cost of ownership, one executive shared learnings from the in-depth analysis of their medical record before arriving at a succinct conclusion –

‘it’s not the kind of thing you can half do’.

The true value of EMR as a pillar of interoperability is partially compromised by a fragmented implementation.

By fully-digitising the entire care management process, institutions can increase operational efficiencies, improve safety and accuracy, streamline workflow, and ultimately, empower clinicians to reduce costs. Naturally, such an extensive transformation requires the alignment of the entire stakeholder base. For many, variability in their stakeholder groups made such a transformation a challenge.

Returning to data as an asset, not everyone around the table was convinced that data had a place on the balance sheet. A rival school of thought soon emerged, one that argued that data was at home on the risk register.

In a threat landscape that is constantly mutating, and with new attack vectors emerging almost daily, there was a shared and calculated trepidation on display concerning the security of digitised health records. This concern was fuelled by a string of recent breaches, both domestic and international, that confirmed medical records as an increasingly attractive target for both individual and state-based attacks. Aggregating high value medical records in one location creates a palpable risk, one that institutions and their executives are not eager to wear.

There was a consensus that these pervading concerns had also cut consumers deeply. A significant percentage of consumers have voted with their feet by opting out of My Health Record, a clear indication that the portrayed benefits of a digitised health record are currently underpowered against highly-publicised privacy concerns.

While providers are consistently shoring their security structures, innovation in this space is shielded from the public gaze. There was little dispute that professional hosting companies are leagues ahead of security in comparison to on-premise data centres, and, by extension, the persisting but archaic physical storage solutions that have become habit for many older clinicians. The challenge is communicating and convincing consumers of these clear privacy advantages in such a complex, opaque, and rapidly mutating security environment.

As one executive noted,

‘I also wonder if the benefit is never going to be realised until you’ve got a saturation point and we certainly don’t have a saturation point’.

A number of challenges must be summited on the path to achieving the mass adoption of digitised health records.

Internally, architects of EMR must inspire a clinician-led cultural renaissance. In the private sector, where visiting medical officers command serious influence, EMR is clashing with a conservative management approach. Administrators are shying away from enforcing new systems, from enforcing change, that may aggravate the visiting medical officers that are so essential to patient admittance.

When it comes to conversing with clinicians, one executive shared his frank elevator pitch:

‘It’ll make life easier for you’.

The answer, in essence, is efficiency – come in, do your job, and go home as efficiently as possible. Appealing to this practical, primitive but important human motive allowed this executive to segue into the next critical question – ‘that’s what’s in it for you, but what’s in it for the patient?’

You can place a tool in front of a clinician and claim that this is going to be good, but if they’re not convinced that it will make a difference to what they care about, patient care, you’ve lost them.

Recognising that interprofessional communication is nearly always the root cause of clinical incidents, the benefits of EMR become abundant – safer prescribing, less medication and eligibility errors, and advanced patient analytics to inform better care.

The endgame now becomes clear – patients will be safer. Active engagement is critical for a successful EMR rollout. By giving clinicians input and fostering a sense of ownership in a solution that is improving patient outcomes, you can create champions for the cause – EMR advocates.

It is undoubted that consumer expectations are soaring, courtesy of fiercely competitive technology giants who operate in climates where user experience is the difference between market domination and failure. These expectations are gradually seeping into healthcare, and now careful attention must be paid to how to engage with technology on the front line.

Technology must augment, and not obstruct or depersonalise, the relationship between clinicians and patients. Particularly, a reoccurring source of frustration for patients is being repeatedly called upon to air the same information. The ability of EMR to resolve this grievance will go a long way towards improving the patient experience and incentivising the mass adoption of digital health records.

As healthcare comes to reckon with consequential technological advancements, the importance of engaging in continuous industry dialogue cannot be understated.

Leaders around Australia are realising that maintaining a technical knowledge of the changing trends, threats and solutions in the EMR space bears heavily on corporate and personal success.

PHILIPS and Connect Media will be continuing this series of executive conversations across Australia, empowering leading organisations to secure the health of the nation.