Epic's rival EHR vendors say they too are making the 'CHR' switch

Cerner, athenahealth and eClinicalWorks said they are incorporating new data types, such as social determinants, population health and precision medicine to make EHRs more “comprehensive.”
By Tom Sullivan
11:00 AM
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EHR vendors and CHR

Epic Systems CEO Judy Faulkner drove a stake into the ground when she said the company is transforming today’s EHR into a Comprehensive Health Record, a.k.a CHR.

But health and IT executives should take note: The new moniker does not mean that Epic has intrepidly moved into undiscovered country. Instead, rival EHR makers are already taking a similar tack. It’s just that no one has publicly attempted such a bold rebranding of the category.

“We’ve been discussing longitudinal health records that include social determinants and other relevant data for at least two years now, and there are more than 100 clients today using Cerner’s population health management platform (including many Epic EHR clients),” Cerner President Zane Burke said. “We’ve worked with these clients to develop solutions like HealtheIntent that are EHR-agnostic and aggregate data from multiple, disparate sources outside the four walls of the hospital or clinic.”

[EHR satisfaction survey 2017: After years of frustrations, user wish-list turns positive]

Cerner is by no means alone in saying it is already working toward a more comprehensive health record. Executives from eClinicalWorks and athenahealth also noted they are broadening the types of information included in the electronic health record — though each is doing so in slightly different ways.

What is a CHR, exactly?

Faulkner said Epic is thinking about how to approach a CHR in three ways. First, the system will include information not in EHRs today; that’s where social determinants come in. Second, the CHR should include data about care delivered outside the hospital. Third, CHRs will incorporate information about care that was traditionally managed inside the hospital but has since or will in the future move outside a provider’s walls, whether via telehealth apps or otherwise.

That’s what Epic means. Here’s what Cerner, eClinicalWorks and athenahealth have in mind.

Cerner’s Burke said the company has worked with its clients to build products – HealtheIntent is one – capable of pulling in data from otherwise disparate sources outside the four walls of the hospital or clinic and are EHR-agnostic.

Burke this week at Cerner’s user group unveiled a free consumer health record for patients that, not altogether unlike the Share Everywhere interoperability tool Epic introduced at its own user group last month, works with a portal to enable patients to access their own information. He also said Cerner would continue to offer interoperability services under the CommonWell Health Alliance free to existing customers until 2020.

And looking ahead Burke promised the vendor would equip next-generation interoperability with the ability for “data to flow freely,” between its own Millennium EHR and other vendors’ software.

eClinicalWorks CEO Girish Navani said his company also envisions the need for a broader platform in the digital healthcare system.

“The EHR is an ever-evolving technology and incorporating further advancements will make enormous impacts in healthcare,” Navani said.  

[Also: Epic CEO Judy Faulkner is standing behind switch from EHRs to 'CHRs']

Navani added that eClinicalWorks’ new EHR, version 11, which was released late last week, consists of cloud-based connectivity, interoperability, intelligence with genetic screening for precision medicine, predictive risk models for population health, and patient engagement features including telehealth services.

When asked about making its cloud-based EHR services more comprehensive in the vein of Judy Faulkner’s plans, athenahealth Chief Product Officer Kyle Armbrester answered that it’s a good step in the right direction.

“What we need more than anything is a platform that’s actually able to work atop all of that information. Just having it sitting there isn’t actually going to solve healthcare problems,” Armbrester said. “We have some of that, where providers capture things, for example, there might be a spouse abuse issue, we capture that.”

That said, there are of course hurdles to creating such a Comprehensive Health Record, according to Blain Newton, Executive Vice President of HIMSS Analytics.  


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“There is absolutely a need to ensure that a patient’s electronic health record is comprehensive,” Newton said. “The challenge has been, and will continue to be, the integration of data not only from within the various EHRs, but the disparate sources that are coming on-line that contain different types of PHI.”

A comprehensive health record also has to keep pace with expanding volumes of data, Newton added, and that requires analytics capabilities running on top of integrated, structured data to distill the right information for providers.

While no vendor has formally rechristened the EHR as a CHR — and that may or may not ever actually come about — hospitals should anticipate their vendors will begin moving in that direction. Just don’t expect it to happen overnight.

“It’s where healthcare must go,” Cerner’s Burke said. “It’s interesting others are just now getting attention for that thought, but it’s certainly going to take more than changing the name.”

Healthcare IT News Editor-at-Large Bernie Monegain contributed to this report. 

Twitter: SullyHIT
Email the writer: tom.sullivan@himssmedia.com