November 2018 Healthcare Hot Takes: The portable EHR is coming. Will it finally put patients in control of their data?

Healthcare Hot Takes is Luma Health’s monthly rundown of healthcare innovations happening right now. Check out what the industry is thinking, reading, doing. This month’s main topic is portable EHR systems.

UnitedHealth Group (UNH) has announced that it will launch a “fully integrated and fully portable” electronic health record for its more than 50 million plan members by the end of 2019. Built on the Rally Health platform, which Optum (UnitedHealth’s IT division) acquired in 2014, the portable EHR hopes to help members better access and visualize their individual health records, while also providing them with next-best health actions.

The most pressing question that arises from this announcement is the ability for the new portable EHR to interface with existing EHRs like Epic and Cerner, so as to integrate within established provider workflows. According to a report from Cantor Fitzgerald, that shouldn’t be a problem as the Rally interface should be able to utilize APIs and other widely used standards to plug into existing EHR systems.

UNH CEO Dave Wichmann hopes that this new EHR can deliver a “deeply personal” experience to each member so as to ensure transparency in care. This means providing individuals with the ability to identify major gaps in care episodes, while also being able to assess the care that they’ve received as a whole.

Luma’s Hot Take: A portable EHR! You already know how we at Luma Health feel about getting patients access to their healthcare in the easiest and most convenient manner for them. This announcement holds a lot of promise for UNH members, but can only truly be successful if it proves to be interoperable with existing data systems. We’re excited to see how it fares!

Young people are going to the doctor less than ever before. According to a 2018 national poll of 1,200 randomly selected adults, 26% stated that they do not have a regular primary care provider. Much more revealing is the breakdown by age: 45% of 18 to 29 year olds; 28% of 30 to 49 year olds, 18% of 50 to 64 year olds, and 12% of 65+ year olds (Source: Kaiser Family Foundation).

With the advent of telemedicine and retail walk-in clinics, millennials find it easier to seek out alternative sources of care right when they need it. Unfortunately, the lack of continuous and coordinated care that a general practitioner would normally provide can ultimately lead to higher healthcare costs. A JAMA report shows that almost half of patients that received treatment at a retail clinic or urgent care center for a cold or the flu ended up leaving with a prescription for antibiotics that proved ineffective or potentially harmful. For those seen by a primary care provider, that number drops to just 17%.

To keep up, practices are employing new ways to attract millenials into their front door. Some are employing more and more providers to increase patient turnaround time. Others are investing in technologies that give patients better access (patient portals) and better communication (like Luma Health!).

Luma’s Hot Take: It makes sense that millennials, used to on-demand conveniences, are taking advantage of alternative sources of care. However, the lack of a continuous and coordinated care cycle can clearly lead to poorer health outcomes and higher overall costs. Therefore, it will be important for primary care practices to continue to entice millennials in innovative ways for regular visits and checkups.

In a story for The New Yorker, Dr. Atul Gawande, new CEO for the Amazon – Berkshire Hathaway – JPMorgan health venture, details his experience with transitioning to the Epic EHR in 2015 at the Brigham and Women’s Hospital in Boston, MA. He describes the frustrations his colleagues experience having to adapt their workflows to an inflexible EHR system, referencing a study that demonstrated physicians spend two hours on the computer for every hour with a patient.

Ultimately, EHRs and data have helped to keep hospitals and physicians accountable for the care they provide to patients, especially with ever-rising healthcare costs. Gawande’s anecdote is a true look into the provider’s perspective, but what about the patient?

As the COO of Partners HealthCare, Dr. Gregg Meyer, puts it, “We think of this as a system for us and it’s not. It is for the patients.” For example, although 60,000 staff at Partners use the Epic system, almost 10 times that many patients log in to the system daily. The ability for patients to view their medical information, including medication history and lab results, in a digitized manner promises to make care easier and more efficient, even if providers must deal with the technological headache.

Luma’s Hot Take: The transition from paper records to EHRs has been and continues to be a real challenge for healthcare providers everywhere. Ultimately, as a software company ourselves, we see the benefits and end goal of a more connected data world for healthcare outcomes. What’s important to us is building software that eases the burden on providers so that they can spend more time doing what they love—treating patients.