Big Data, EHRs, and Patient Care: How Healthcare Is Evolving

As part of our Practice Manager Viewpoint Series, we present a conversation with Shereese Maynard, a healthcare and health IT strategist based in Salisbury, Maryland.

Q: What issues are you focused on in the evolving healthcare environment?

Shereese: I’m a healthcare IT (HIT) adoption and policy strategist. I have been in the healthcare field since 2001. I currently work with independent practices, helping them to adopt and understand new technologies and put frameworks in place that encourage efficient workflows, coupled with policy structure. My focus currently is on blockchain technologies and interoperability challenges. I’m working with providers in New Mexico, connecting three facilities and developing their data aggregation program.

Q: The Doctors Company’s recent analysis of our closed claims database revealed that malpractice claims involving electronic health records (EHRs) have risen continuously over the past 10 years, with both system factors like failure of decision alerts and user factors like copy-and-paste errors playing a role. Where do you see the role of EHRs in the current landscape? What are your concerns about their use and their risks?

Shereese: EHRs are here to stay and for a very good reason: EHRs, while still in infancy, improve care coordination. Admittedly, we’ve hit a little bump in the road as clinicians and organizations try to find the best EHR workflow. There is no one-size-fits-all EHR solution. Organizations have to first define who they are, who their patients are, and look for solutions that best speak to their customized needs. I think we’ll see better EHR products being produced, and I also think, with the current EHR vendor leaders only garnering a 1/10th market share, we will see some new vendors emerge with better EHR products being produced. Physician-led developers will drive this innovation.

Q: Cyber attacks continue to dominate the news—with healthcare being the most attacked form of business. How do you address cybersecurity concerns in your role? What are your biggest cybersecurity concerns?

Shereese: Cybersecurity has to be a concern for all organizations. We continue to see breaches across the U.S., but I think it's an area where organizations are still in denial. We’re taught to hide our vulnerabilities, but when it comes to cybersecurity challenges, organizations need to be more transparent. I often remind providers that pretending a vulnerability doesn’t exist isn’t the same as not having one. As organizations update technologies, they need to insist on full-system conversions and invest in cyber insurance comparable to the value of their data. Also, cybersecurity training for staff should be native to systems. Having one training session per year doesn’t help staff retain information and is not the best defense against attacks. We’re seeing some great movement in the area of blockchain uses in healthcare, which I believe will go a long way toward securing patient data.

Q: What do you see as the impact of health IT on the physician-patient relationship, both good, bad, and neutral? What strategies do you use to mitigate some of the challenges?

Shereese: It’s my belief that HIT integration is a long-term strategy that will greatly improve the physician-patient relationship. We’ve stumbled a bit in this area, as physicians struggle to use the EHR efficiently in the exam room. This will change, in my opinion. The ills we feel in-house are not necessarily being seen by patients. Several studies now suggest that while doctors feel HIT is hindering the relationship between physician and patient, patients are reporting no change. Vendors can help mitigate some of the challenges faced by physicians by adding the patient and physician “voice” to HIT design thinking. As more customizable solutions are made available and physician input becomes a greater part of the HIT strategy, products that improve communications will rule the day. 

Q: What do you see as the biggest challenges facing healthcare practices today? Where are the biggest areas for improvement?

Shereese: The two biggest challenges to healthcare today, in my opinion, are data strategies and management of human resources. Healthcare, always five years behind other industries in the area of innovation, has not transitioned into a data-driven industry well. We have not understood data aggregation and we are not using data well. Our systems are fragmented and our initiatives are too segmented. We’re not all on the same page with:

  • Who owns the data?
  • What is actionable data?
  • What languages should we use to define the data? For example, there are currently 12 ways to define a date, and there are at least four terms to define data science.
  • How are we to use this big data to improve health outcomes?

Second is our management of our human resources. Healthcare needs to dedicate more resources to ongoing training, as this is the greatest investment we can make to ensure sustainable workflows and patient satisfaction. We need to cultivate our own data scientists. Teaching current talent to evaluate and extrapolate data cuts costs and has a buy-in component that is a benefit to the organization. The turnover in healthcare is higher than in other industries because of our failure to reinvest in talent.

But I believe that in healthcare we are seeing an improvement in leadership. New voices, some coming out on social media, are disrupting the healthcare landscape. The qualities we seek out in leaders in other industries are now being recognized in healthcare. We’re finally hearing more diverse voices—as I often say to organizational leaders, “If everyone in your organization looks and thinks exactly as you do, you’ve got a big problem.”

Read more articles in our Practice Manager Viewpoint Series:


The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

04/18

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