The unmet need for a cross-platform electronic health record (EHR) is a key component for healthcare systems looking to move forward. As companies focus on cloud-based solutions, in addition to numerous companies vying for business boasting “streamlined electronic health records”, many healthcare systems still face obstacles to providing personalised health solutions for better patient outcomes.

Currently, there are numerous vendors that provide EHR conversions for practices stuck in a more traditional epoch. Companies such as Athena Health, Cerner Corporation, Epic Systems Corporation, and Allscripts provide EHR solutions. However, these systems are proprietary software that lack connectivity and interoperability. Solutions such as these are hard to implement on a municipal level as patients tend to obtain healthcare from numerous settings including primary, acute, ambulatory, and community care.

A recent initiative taken by the Ontario government in Canada, the aptly titled ‘Connectivity Strategy for EHealth in Ontario’ plan, enables healthcare key stakeholders to create a safe, cost–effective, and provincially integrated EHR. The plan includes specifications to leverage open industry standards and specifications and by avoiding proprietary vendor interoperability specifications.

The US has taken steps to delve deeper into the health IT paradigm shift to provide better health records for improved patient outcomes. The US Department of Health and Human Services (HHS) offers incentive payments to healthcare providers who adopt and demonstrate meaningful use of certified EHR technology. However, the federal government does not dictate which EHR systems should be used or provide any plan to aggregate information across multiple EHR systems, which creates a mosaic of non-standardized health information.

In addition, a prominent issue with this method is the misuse of the program to attain incentive payments from the government. In December 2017, 21st Century Oncology paid a settlement of $26m to the government to resolve allegations that the centre had submitted false attestations to receive incentive payments.

The UK’s National Health Service (NHS) has a negative experience with trying to implement a nationwide EHR. The NHS invested £12.7bn ($17.6bn) into the National Programme for Information Technology; the program was intended to create a national EHR system in addition to eliminating the challenges of interoperability due to varying proprietary EHR systems. A major hurdle for the program was weak management resulting in unrealistic completion dates and budgets. In addition, there was no alignment between the stakeholders such as clinicians, software designers, and prospective end users of the software. The program was terminated in 2011 after nine years of investment, planning and implementation.

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These three examples of governments trying to execute EHR initiatives demonstrate the multifaceted issue of creating a standardized EHR system. However, to create a holistic healthcare system, one single EHR is an inevitable reality that must be achieved. Reaching a viable solution will take time and the involvement of all key stakeholders as it is key for better patient outcomes in a healthcare industry moving towards personalised health.

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GlobalData (2016). North America Clinical IT Systems Market Outlook to 2022, October 2016, GDMECR0450DB

GlobalData (2016). EU5 Clinical IT Systems Market Outlook to 2022, November 2016, GDMECR0459DB