Regardless of the technology with which they are developed, electronic health records can be classified by objective and functional nature.
As a consultant, I often read technical specifications for electronic health record (EHR) tenders or attend presentations on this matter. As I’ve already wrote on this blog, very often I don’t see any real innovation but the use of more advanced development technologies.
To understand if this is my own personal feeling or something more objective, I did some research on the web and I found a classification by Gartner, but not recent, on the different generations of CCEs.
Gartner divides files into five generations:
Generation 1 – The Collector
This generation enables site-specific, encounter-based access to clinical data. The EPR system is not yet very connected to other systems, it strictly displays data. It is used as a results-reporting tool and offers multiple users’ access to clinical data.
Generation 2 – the Documentor
This generation provides the users with clinical documentation along-side the patient’s records. It gives clinicians the possibility to add (store/write) and edit data in the patient’s record. And provide support to message GP’s.
Generation 3 – the Helper
This generation monitors the data in order to aid the users supporting their processes. The EPR offers support for the care-process supporting activities like order-management, nursing care plans and clinical paths. There is not much ‘intelligence’ applied to the data. Just some basic rules and protocols are entered into the system.
Generation 4 – the Colleague
This generation aids the user in predicting and predicating the workflow of the user. So much data is stored, intelligence is applied to and a knowledge base is generated. Combining data from multiple sources, the EPR system can make actual suggestions to improve the patient’s wellbeing.
Generation 5 – the Mentor
Gartner’s most sophisticated generation documented. This generation of EPR systems is able to guide the users in caring for the patients.
Generation 1: Collects and displays information
Generation 2: Makes information interactive
Generation 3: Applies basic rules to information in the system
Generation 4: Changes the workflow for the end-user based on information in the system
Generation 5: Guides doctors during the care process.
It is very interesting to observe the time scale that appears in the graph!
Considering the functionalities and objectives of the EPRs that I often observe (generation 2 and 3), I must say that the perception of immobility or conceptual backwardness is unfortunately confirmed by this classification.
To complete the picture, some define a new generation of EPRs, the sixth, called The Seer (the soothsayer, the forebearer), in which predictive analysis functions support doctors in assessing the risks and possible evolutions of patients’ health.
Among the main objectives of the EPR is the reduction of preventable errors found in the ordinate axis of the graph. This is a very important issue to which I will soon devote a separate post.
So, what is the generation of your electronic patient record?