| Patient-facing |
Patients access EHR data using third-party app Patients download and use claims data from health plan in
third-party app Patients use single app to schedule appointments across
all their providers
|
EHR data are easier for patients to review, aggregate,
share, or use for health-related decisions and
activities Payer data can help patients make decisions that take
costs into account
|
Business model for patient-facing apps are lacking Value to patients of aggregating EHR data or claims data
alone may be limited Variable workflows (eg, for scheduling) present
challenges for write-based use cases EHR vendors do not always publish endpoints or make it
easy to register apps EHR data may be missing or incomplete Patients may not trust app companies with their data
|
| Clinician-facing |
CDS apps extend EHR functionality, allowing
customizations not natively supported by EHR App is developed at 1 institution and easily installed at
a different system Clinicians can access data from another healthcare
system
|
Facilitates innovation in EHR-based functionality by
extending core capabilities; new features can improve
care in myriad ways (eg, clinical decision support,
workflow improvement) Improves clinician professional satisfaction through more
usable tools
|
Fee structures for app developers may limit
innovation Data elements available via API vary by vendor so
proprietary APIs are still needed Surfacing apps in workflows is challenging (low adoption
of CDS hooks) Writing back to APIs is complicated by downstream
business logic
|
| Population health and value-based care |
|
Makes more data available for clinical decisions, reduces
data collection burden, allows for tracking follow-up
visits, enables standardization and reuse of analytic
tools Standardizes chart abstraction to enable automation and
replace expensive, manual, error-prone processes
|
Lack of trust among providers with sharing data with
other providers and with payers FHIR endpoints not established among most providers Integration of data in workflow is challenging
|
| Public health |
Provider sends and receives immunization data to public
health reporting agencies Public health agency receives reportable electronic case
data from provider EHR Patient accesses immunization data through app (through
EHR or from registry directly)
|
Improves accuracy, quality, completeness, and timeliness
of data for public health decisions, forecasting needs,
and use in clinical care More efficient data exchange to meet regional and federal
reporting requirements
|
|
| Administrative |
Prior Authorization determinations—bidirectional
exchange between provider and payer Eligibility checking—bidirectional exchange
between provider and payer Payer exchange (of claims data when patients switch
plans)
|
Standardizes payer–provider interaction to improve
efficiency and accuracy of payment-related
determinations Makes it easier for new payer to access claims history
for coverage decisions, especially valuable for patients
with multiple chronic conditions
|
Lack of trust between payers and providers with
exchanging data (value-based contracts better align
payer–provider incentives when both parties bear
risk) Payers lack experience and work processes for giving
real-time responses to prior authorization
determinations
|
| Integrating clinical and social services |
|
Facilitates integration of standards-based social risk
assessment questionnaires into EHR Enables clinicians to query social services for
capabilities/availability, and execute/track
referrals
|
Social services lack IT infrastructure and money Capture of social data is unreliable in EHRs and would
require workflow changes Unclear financial incentives for data sharing
|
