Will patient-generated data ever be included in EHRs?

Industry considers integrating patient-reported outcomes into EHRs

It is no secret that the health care industry has been pushing for enhanced patient engagement to improve care quality across the nation. In addition to establishing better patient outcomes, patient engagement is necessary for adhering to the stage 2 and 3 meaningful use standards. The promise of financial incentives from the Centers for Medicare and Medicaid Services under the EHR Incentive Programs is one of the reasons why so many providers have adopted electronic health records over the past year.

In order to receive these incentives, however, health professionals have to ensure that their practices are showing more interaction with patients through encouraging them to use patient portals. Although patients are slowly getting more control over their health, experts are wondering if the industry should take this one step further and provide them with the ability to input patient-reported outcomes into EHR systems. 

Most providers rely on patient-reported information
A recent survey by Cutting Edge Information found that many providers support giving patients the ability to provide these outcomes within their practice's health IT. A total of 68 percent of clinical trials at some of the health care sector's leading companies used patient-reported outcomes. Meanwhile, 90 percent of small pharmaceuticals that develop clinical trials have begun incorporating patient-generated data into their EHR systems. 

"Although [patient-reported outcomes] are increasingly embraced in the pharmaceutical industry, life science organizations must not rely solely on these measures to support regulatory approval," Victoria Cavicchi, research analyst at Cutting Edge Information, said in a public statement. "Teams should play a balancing act and incorporate the right mix of traditional clinical evidence with patient responses to build the strongest case for emerging products."

Would clinician teams performing drug trials benefit from patient-reported outcomes? With the industry pushing for improved patient engagement strategies, many health professionals believe that patient-generated information will assist clinicians in determining the effects of certain medications and their success rates. Many life science businesses have started including this type of data in their trials to make sure that all side effects are recorded for each medication they test. It may be that providers in other areas of the industry begin to enable patients to include data in their EHR systems as well.

Barriers to including patient-generated data
One of the obstacles that providers including this information in their systems would have to face is the approval of the Food and Drug Administration. Most of the industry's biological endpoints are more likely to be approved by the FDA for trial inclusion compared to patient-reported outcomes. 

According to a case report published in the Journal of the American Medical Informatics Association, FDA approvals are not the only barrier that providers will have to overcome if patient-reported data inclusion becomes a widely used tool for boosting patient engagement. The report highlights several of the issues that providers may run into after including this information in their EHR systems. 

To determine these specific obstacles, researchers performing the case study took into account various clinical observations from providers, their staff and patients. They also considered the written feedback provided by end-users. Some of the expected barriers discussed most frequently were problems with workflows and feelings that clinicians would not, in fact, benefit from patient-generated data. 

If patient-reported outcomes are going to be a successful addition to health IT in the future, EHRs will need to have features like usable interfaces and process automation. The ability for EHRs to collect patient-reported outcomes that are relevant to clinical trials is also crucial, as this will reduce potential burdens placed on patients and providers. As the industry continues to create new uses for health IT, providers can expect to see patient-reported information included more frequently throughout the sector.