FEATURE
found that 93 percent of hospitals and health
systems allowed patients to view their health
records online, up from 27 percent in 2012. 16
“The problem with having patients
holding their own data is that you still need
the information to be vetted by the domain
experts,” said Dr. Zelenetz. “If the patient is
going to go around with his [or her] own
portable health record, that information still
needs to be evaluated, entered, and shared
with other systems.”
Version 2.0 and Beyond
According to Dr. Adler-Milstein, the dis-
satisfaction with EHRs stems from the great
expectations with which they were intro-
duced. In context, she said, EHRs are still a
young technology.
“One mistake was framing EHRs as a
near-term win, thinking we’re going to get
the value back within five years. That was way
too short of a timeline,” she noted. “We may
be approaching the 20-year mark, but most
of the progress has been made in the last
decade. I would consider us still in the first
generation of these technologies.”
With each new generation, Dr. Adler-
Milstein expects successive improvements,
including greater use of application program-
ming interfaces (APIs), software intermediar-
ies that allow applications to communicate.
APIs will make it easier to get data in and out
and will usher in “EHR Version 2.0.” “It will
probably be another 10 years before everyone
feels the technology’s working well and deliv-
ering value,” she predicted.
For all the complaints he hears, Dr.
Zelenetz doesn’t think many clinicians would
opt to go back to paper records. And for he-
matology/oncology, specifically, he sees great
potential. “We have real opportunities, but we
don’t yet have, for example, an understanding
of how to best define an oncology history or
how to integrate pathology diagnoses with
the chemotherapy history so we can see it all
at once. We have made big strides, but
we haven’t solved all the problems.” —By
Debra Beck ●
REFERENCES
1. Henry J, Pylypchuk Y, Searcy T, et al. Adoption of electronic
health record systems among U.S. non-federal acute care
hospitals: 2008-2015. ONC Data Brief. 2016;35:1-11.
2. HealthIT.gov, “By The Numbers: Our Progress In Digitizing
Health Care.” Accessed March 8, 2018, from www.healthit.
gov/buzz-blog/health-data/numbers-progress-digitizing-
health-care.
3. Adler-Milstein J, Jha AK. HITECH act drove large gains in
hospital electronic health record adoption. Health Aff.
2017;36:1416-22.
4. HealthIT.gov, “Office-based Health Care Professional Par-
ticipation in the CMS EHR Incentive Programs.” Accessed
March 10, 2018, from https://dashboard.healthit.gov/
quickstats/pages/FIG-Health-Care-Professionals-EHR-
Incentive-Programs.php.
5. HealthIT.gov, “Hospitals Participating in the CMS EHR
Incentive Programs.” Accessed March 10, 2018, from
https://dashboard.healthit.gov/quickstats/pages/
FIG-Hospitals-EHR-Incentive-Programs.php.
6. Medscape, “Abraham Verghese: ‘We Are Responsible’ for
EHR Dysfunction.” Accessed March 11, 2018, from www.
medscape.com/viewarticle/884352.
7. Brockstein BE, Hensing T, Carro GW, et al. Effect of an
electronic health record on the culture of an outpatient
medical oncology practice in a four-hospital integrated
health care system: 5-year experience. J Clin Oncol.
2011;7:e20-4.
8. Harshberger CA, Harper AJ, Carro GW, et al. Outcomes of
computerized physician order entry in an electronic health
record after implementation in an outpatient oncology
setting. J Oncol Pract. 2011;7:233-7.
9. HealthcareIT.gov, “Meaningful Use Definition & Objec-
tives.” Accessed March 11, 2018, from www.healthit.gov/
providers-professionals/meaningful-use-
definition-objectives.
10. HealthcareITNews, “Meaningful use will likely end in 2016,
CMS chief Andy Slavitt says.” Accessed March 11, 2018,
from www.healthcareitnews.com/news/meaningful-use-
will-likely-end-2016-cms-chief-andy-slavitt-says.
11. Sklarin NT, Granovsky S, O’Reilly EM, et al. Electronic
chemotherapy order entry: a major cancer center’s imple-
mentation. J Oncol Pract. 2011;7:213-8.
12. Healthcare Information and Management Systems Soci-
ety, “What is Interoperability?” Accessed March 12, 2018,
from www.himss.org/library/interoperability-standards/
what-is.
13. U.S. Department of Veterans Affairs press release, “VA
Secretary announces decision on next-generation
Electronic Health Record.” June 5, 2017. Accessed March
12, 2018, from www.va.gov/opa/pressrel/pressrelease.
cfm?id=2914.
14. Becker’s Hospital Review, “Hacking responsible for 83%
of breached records in January, insiders 1%: 6 things to
know.” Accessed March 8, 201