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Moving From Problem-Oriented to Goal-Directed Health Records.
Zsolt J Nagykaldi1, Huibert Tange2, Jan De Maeseneer3
1Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma znagykal@ouhsc.edu.
Annals of Family Medicine
|March 14, 2018
Summary
Current electronic health records (EHRs) fail to prioritize patient needs. A new EHR design is proposed to center care around patient goals, improving health outcomes and clinician experience.
Area of Science:
- Health Informatics
- Patient-Centered Care
- Healthcare Systems Design
Background:
- Existing electronic health records (EHRs) were developed within a disease- and payment-focused model.
- This traditional paradigm often overlooks the unique goals, needs, and values of patients and clinicians.
- A goal-directed health care model has been conceptualized but lacks corresponding EHR design principles.
Purpose of the Study:
- To identify the limitations of current EHR systems.
- To propose a blueprint for a novel EHR design that supports goal-directed healthcare.
- To facilitate healthcare anchored by patient life and health goals.
Main Methods:
- Exploration of current EHR system limitations.
- Proposal of 5 major system functions for goal-directed health records, based on the Institute of Medicine's 8 characteristics of primary health care.
- Discussion of necessary transformations in payment and quality measurement systems.
Main Results:
- Current EHRs are misaligned with patient-centered care goals.
- A new EHR design blueprint is presented to integrate patient goals throughout the care continuum.
- The proposed design emphasizes 5 key functions derived from primary healthcare principles.
Conclusions:
- Patient life and health goals can drive healthcare delivery with appropriate EHR design.
- Synchronized shifts in healthcare provision, documentation, and payment models are essential for success.
- Implementing goal-directed EHRs requires a holistic transformation of the healthcare ecosystem.
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