by Angela Guess
Shahid Shah of HealthcareITNews.com recently discussed the potential value of designing more effective electronic health record (EHR) data models. Shah writes, “Current EHR apps are usually restricted to ‘legal entities’ (e.g. a single hospital or a hospital system or single ambulatory practice). To manage integrated and coordinated care, successful EHR systems must open themselves up beyond legal boundaries but most of them have created their databases and data models to preclude that capability. Most existing EHRs, even modern ones that were built for meaningful use, have traditionally done a poor job understanding and designing ‘multi-entity’ or ‘multi-tenant’ database models that would encourage secure, trusted, electronic collaboration between legal organizations (e.g. two hospitals or multiple clinics) and patients as they move across entities.”
Shah continues, “This is due not to the lack of availability of good design patterns but a lack of comprehension that tomorrow’s shared savings initiatives, capitated payment models, ACOs, and PCHMs require a level of coordination and amount of measurements of quality metrics that are tough to define, implement, and secure. Future EHRs cannot be seen as applications alone but as broad care coordination platforms that must allow dynamic business models that can accommodate a great deal of uncertainty and flexibility, especially with respect to legal boundaries.”
