Digital healthcare ecosystems are a popular topic at the moment, but what are the needs of a digital ecosystem? How can the value of an electronic patient record (EPR) be optimised in the context of a digital ecosystem? It is important to consider these questions in order to understand and achieve the many benefits that can be associated with an EPR.
Different approaches to EPRs
There tends to be two mindsets surrounding the definition of an EPR; a single EPR system as a software solution or an EPR as an ecosystem of interoperable software solutions.
EPR as a single solution
When an EPR is viewed as a software solution, it is built to integrate clinical workflow and documentation into a single solution. This provides benefits, such as less integration and less system learning for staff, but it can create other issues. Ironically, the "one size fits all" approach often ends up not fitting anyone. It can result in clinical teams being unable to coordinate their tasks through the one interface they have, which creates a serious problem where they communicate with one another in an ungoverned manner. EPRs can hinder innovation if they are not used effectively. Healthcare organisations may become bound in rigid procedures that restrict their ability to evolve.
EPR as part of a solution
When an EPR is viewed as an ecosystem of interoperable software, the patient record is separated from utility and software. Regardless of where the data originates, the record captures information and establishes relationships within and between data. The programme collects data from multiple sources, after which it is decoupled from the software and customised to meet the requirements of specific users. Innovation can flourish whilst also preserving the integrity of the single data record kept centrally on the patient record. There are several essential elements required. To achieve consistency in the data models, this strategy needs a common language amongst systems. Interoperability must be a primary implementation goal, rather than an afterthought. Additionally, the software solutions that feed into the record must be scrutinised to ensure they are appropriate for their intended use, secure, and compliant with cyber security requirements.
The 3 pillars of a digital healthcare ecosystem
EPRs can thrive and their value can be maximised as part of a digital ecosystem, but what are some key factors to consider? The needs between organisations, hospitals, and even within specialties differ greatly which means the needs of digital ecosystems are often vast, complex, and wildly variable. They must address multiple needs and work across different teams. Factors like integration between clinical and administrative workflows, or cohort and volume traffic management can affect the implementation and success of an EPR, creating barriers to technological adoption. Therefore, a digital healthcare ecosystem needs to be future-proofed, user-centred, and transformative.
What is the desired outcome at the end of the transformation? What will digital health look like in 10 years? A future-proof system will enable organisations to be prepared for challenges that will become more prevalent. This involves evaluating the system both technologically and clinically. Future-proofing in terms of technology can mean using more ML and AI algorithms. Clinically, it can entail a larger focus on regional, specialty-specific pathways, or collaborative cross-site functioning. Additionally, it's essential to consider a future-proof strategy for variables that are currently unknown. Although the idea of future-proofing for the unknowable might be challenging, it is key to consider these concepts when implementing EPRs to maximise their value both immediately and in the long-term.
The success of digital solutions within an ecosystem depends entirely on the engagement of its users and stakeholders, making it vital to be user-centred within the design, workflow, how the interface works, and within the functionality. The stakeholders are often multiple clinical, administrative, and managerial teams all with different levels of digital literacy, engagement, and internal or external commitments and pressures. This creates more complexity and variability to the needs of the ecosystem but remains critical in achieving the required engagement.
Transformation first, digital second
Digitising patient records so they can be viewed on a screen should serve as the starting point and not the target endgame. If legacy processes designed for a different time with different needs are integrated into a software, you end up with old processes on a screen. The processes must be streamlined to suit current clinical and healthcare needs. True digital transformation occurs at all levels, from individual departments, across hospitals and specialities, and across regional pathways. This allows frequent scale up to innovation, staying current with guidelines that are different for individual departments, teams, or specialties, which circles back to future-proofing. It allows the capture of targets unique to those specialities at a granular level, all whilst integrating with the EPR through a single data repository available and accessible by everyone within the organisation. Digital transformation must involve consultation to change the way processes are performed and managed. Once the process evolves, then it becomes easier to layer in the technology enabling the delivery of better patient care. Digital transformation is creating an ecosystem of solutions that together are greater than the sum of their individual parts, and it is critical to get it right for the EPR.
Open Medical’s mission
At Open Medical, we successfully implemented our digital solution PathpointⓇ in over 100 sites across the NHS and HSE. We join healthcare providers on their journey towards digital transformation to deliver streamlined clinical workflows, coordinate distributed teams, and enable seamless collaboration. We are helping to bridge the gap across primary, secondary, and tertiary care while transforming the existing processes. This journey is not a one-off, it will adapt and evolve constantly over the years. Therefore, we partner with healthcare organisations on that journey and provide our expertise in healthcare consultancy, digital transformation, and software engineering to guide the provider to achieve their own strategy aims. We help them realise the value they are getting from their EPR, rather than simply inserting our own solution.