Modern Technology Frontiers of EHR Innovation

Ganesh Subbaiyan is the Director of Program Delivery for Healthcare vertical at KANINI. He champions technology-driven EHR innovations that prioritize patient engagement and collaborative care. Collating all his experiences working in the EHR space, he has put together his thoughts on how he envisions EHR technology companies to prioritize the end-users of the platform – providers and patients.

I’ve seen firsthand the evolution of Electronic Health Records (EHRs) and the increasing potential of artificial intelligence (AI) to revolutionize the healthcare sector, having worked closely in this industry. In this article, I’ll share insights on the changing landscape of EHRs, the challenges and opportunities we face, and how innovative companies like PIMSY EHR are leveraging AI to empower healthcare providers and improve patient outcomes.

Electronic Health Records (EHRs) have undeniably revolutionized healthcare, digitizing vast amounts of patient information and making it accessible to providers and researchers. As we see the rise of sophisticated data analytics and AI-powered tools built on top of EHRs, the promise of personalized care and predictive diagnostics becomes more tangible. Yet, even with these exciting advances, a critical truth remains – EHRs are still fundamentally about people: patients and the healthcare providers who serve them.
In our race to harness the power of data and AI’s power, we mustn’t forget the human element at the core of healthcare delivery. To maximize the impact of EHRs, I believe we need to prioritize EHR innovation that fundamentally improves the user experience, streamlines workflows, and fosters stronger relationships between patients and providers.
In my conversation with Ian MacDonald, the Founder & CEO of PIMSY EHR, he emphasized that the future of healthcare is about access and choice. We need to expand access to healthcare, embrace telehealth and virtual care, and empower patients with tools to manage their own health more proactively.

The future of healthcare is about access and choice. We need to expand access to healthcare, embrace telehealth and virtual care, and empower patients with tools to manage their own health more proactively.

Ian MacDonald, Founder & CEO of PIMSY EHR

Challenges of EHR Companies and Solutions to Tackle Them

Imagine a world where EHRs are intuitive and efficient, designed to support the way clinicians naturally think and work. A world where information is readily available at the touch of a button, and the process of documenting care is streamlined and effortless. A world where the collaboration across the care delivery chain is seamless and the focus is on improving patient outcomes with robust engagement initiatives. This may seem like a utopia given the challenges that present-day EHRs face, but it’s a vision that’s well within reach. I will shed light on some of these challenges and how I propose to tackle them!
1. The Tyranny of Clicks – Usable Design as the Bedrock of EHR Innovation
I’ve heard countless stories from physician colleagues about the staggering amount of their day spent navigating EHR systems. A 2020 study published in the Annals of Family Medicine confirmed this – showing doctors spending roughly 16 minutes on EHR interactions and clerical work for every 30 minutes of direct patient care. The constant clicking, scrolling, and searching through poorly designed interfaces is a massive contributor to physician dissatisfaction and burnout.
The Solution: Adopt Design Thinking for Healthcare
I strongly advocate for the next wave of EHR innovation to embrace design thinking principles. Healthcare is incredibly complex, but user interfaces don’t have to be. Here’s how user-centered design can make a difference:
  • Workflow-driven: EHR systems should mirror the natural flow of how clinicians think and work. Information needs to be readily available with minimal clicks, and the path from symptom assessment to treatment plan must be intuitive.
  • Task-focused: Design elements should enable, not hinder, common tasks. For example, refilling prescriptions should require minimal data entry, with defaults and auto-population wherever possible.
  • Visually Uncluttered: A clean interface that strategically uses white space and clear visual hierarchy allows providers to quickly find what they need, reducing decision fatigue and errors. Furthermore, EHRs should be adaptable and customizable to meet the unique needs of different specialties and care settings.
  • Affordable Pricing: Designing the EHRs should align with the growing trend of offering flexible subscription plans, recognizing the varying needs and budgets of different practices, particularly smaller ones.
While AI features bring about revolutionary transformations, the streamlined design of routine tasks can make a huge difference in how clinicians feel about using EHRs.
2. The Burden of Documentation – When EHRs Get in the Way
From my experience, physicians often feel bound to the EHR. Hours spent meticulously documenting patient encounters for billing and compliance take up valuable time that could be spent building a connection with the patient. It’s no surprise that many physicians feel that the EHR has squeezed humanity out of medicine.
The Solution: Reinvent Clinical Notetaking
I envision EHR progress notes becoming more than just records for billing purposes. PIMSY EHR’s CEO Ian MacDonald also mentioned that EHR medical note data holds a treasure trove of hidden insights that can significantly enhance care delivery. These can actively support better care through:
  • Auto-structured Notes: Tools that intelligently structure notes based on conversational input can be a huge time-saver. Imagine a physician discussing a patient’s hypertension treatment – a well-designed system should intelligently insert relevant data under headings like “Blood Pressure,” “Medication,” and “Lifestyle Changes,” without the need for excessive clicks.
  • Voice-to-Text Revolution: Voice recognition has come a long way, and it is exciting to see its potential. However, current implementations still need refinement. The goal should be to have voice-to-text that accurately understands medical terminology and its context, producing semi-structured notes that are easily editable.
  • Less is More: The documentation of patient data shouldn’t be done just for the sake of it. We need systems that intelligently highlight what’s clinically relevant. For instance, a patient’s complex medical history could be briefly summarized, allowing us to focus on the critical points from the current visit.

Medical session notes hold a treasure trove of hidden insights that can significantly enhance care delivery.

Ian MacDonald, Founder & CEO of PIMSY EHR

3. Collaboration Constraints Across the Care Continuum – Siloed Care
Healthcare is highly fragmented. Patients often receive care from multiple specialists, and ensuring the smooth flow of information between providers has been a perennial challenge. This fragmentation is particularly pronounced in behavioral health, where collaboration between mental and physical health providers is crucial for comprehensive patient care.
The Solution: Take a New Approach to Interoperability
In my view, true interoperability isn’t just about the technical exchange of data, but the seamless ability for multiple care providers to collaborate around a shared, real-time patient record. Here’s what’s needed:
  • Shared Care Plans: Moving beyond static discharge summaries, we need EHRs that facilitate the creation of dynamic, living care plans. These plans should be visible and editable (with appropriate permissions) by all members of a patient’s care team.
  • In-Context Communication: Messaging features embedded within the EHR shouldn’t exist in a silo. A specialist requesting a cardiologist’s opinion, for example, should be able to do so directly from the relevant section of the patient record.
  • Data Portability for Patients: Patients need a greater, more user-friendly role in their data. EHRs of the future should have patient interfaces that give them clear control over what information they share, with whom, and for how long.
4. Evolving Patient-Provider Relationship – Increasing Patient Expectations
I’ve witnessed the practice of medicine shift away from the traditional paternalistic model. The rise of consumerism in healthcare, coupled with the wealth of information available online, has empowered patients, and they now expect their voices to be heard. However, with such a proliferation of information, there is every chance that patients can get misinformed. In fact, in one of our conversations, Ian said that emerging technologies like Generative AI can be used in chatbots and virtual assistants to keep patients well-informed, engage them, and make them feel more involved in the process. For that, EHRs should have good patient engagement capabilities built within.
The Solution: Build EHRs as Patient Engagement Tools
I see EHRs becoming powerful tools for patient empowerment and shared decision-making:
  • Accessible Records and Notes: Patients should have easy access to their own records, including clinical notes, in a format they can understand.
  • Educational Resources: Imagine an EHR that automatically displays patient-friendly, trusted educational content linked to diagnoses or prescribed medications.
  • Two-Way Communication: Secure messaging platforms built within EHRs can facilitate convenient communication between patient and provider, enhancing follow-up and streamlining tasks.
All the solutions I talked about require the usage of technology in a way that is unconventional. And in the process, there is a chance that we might get carried away and overlook the very fundamentals and the actual purpose behind why we have EHRs.

Emerging technologies like Generative AI can be used in chatbots and virtual assistants to keep patients well-informed, engage them, and make them feel more involved in the process. For that, EHRs should have good patient engagement capabilities built within.

Ian MacDonald, Founder & CEO of PIMSY EHR

Limitations and Ethical Considerations of Technology Innovation

Technology innovation must be brought in with caution, and I will talk about some of the considerations to have in mind, before diving into execution. As we push the boundaries of transformation using technology, it’s important to remain mindful of the limitations and potential downsides of EHR innovation:
  • The Digital Divide: Not everyone has equal access to technology or the skills to effectively use online portals and tools. We must design solutions that don’t worsen existing health disparities.
  • Alert Fatigue: I’ve seen firsthand how excessive alerts and pop-up windows can interrupt workflow and desensitize physicians. We need smarter algorithms that present only the most relevant and actionable alerts.
  • Bias Amplification: The design of interfaces or the way clinicians are nudged towards certain actions can subtly introduce bias into decision-making. It’s crucial to continuously audit for unintended consequences. Furthermore, the increasing reliance on AI in healthcare raises questions about transparency and accountability. We must develop and implement clear guidelines around the use of AI, ensuring that it’s used ethically and responsibly, with a focus on patient well-being and safety.

The Road Ahead

I’m optimistic about the future of EHRs. The next decade will see a maturation of user-centered design, the seamless integration of disparate systems, and a stronger focus on enabling collaboration and patient agency.
It’s an exciting time to be a part of the healthtech industry, driving innovations that not only improve efficiency and the potential of medical discoveries but also make healthcare more accessible and humane for everyone involved.
At KANINI, we strongly believe that robust and user-friendly EHRs are what the healthcare industry needs today to deliver the best patient care – the ultimate goal of the whole healthcare ecosystem. Our team of passionate healthcare technologists is dedicated to EHR modernization and creating custom and user-centric solutions that can be integrated with EHRs to streamline workflows, empower providers, and foster stronger patient relationships.
Join us in our commitment to build a future where EHRs are functional, intuitive, efficient, and truly patient-centered.

Ganesh Subbaiyan
Ganesh Subbaiyan is the Director of Program Delivery for the Healthcare vertical at KANINI. With a proven track record of leading complex technology initiatives in healthcare, his expertise spans quality assurance, agile methodologies, and cloud migration. His passion lies in streamlining healthcare processes and enhancing user experiences through technology. As a firm believer in the power of technology to transform healthcare, he champions EHR innovations that prioritize patient engagement and collaborative care.
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