A Quick Guide to EHR Integration for Health Apps

There are hundreds of apps available for EHRs in public-facing marketplaces, distributed across focus areas from administration to patient care to provider support. But while they are relatively easy to access through marketplaces, they are often hard to access within the context of using EHRs and performing work tasks. This does not include the thousands of web applications that are not integrated with EHRs.

The apps fail to interact directly with EHRs, don’t relay information properly into the records, and are hard to navigate within or adjacent to EHR ecosystems. This app integration failure is a major roadblock for both clinicians who want to use them and the companies that developed them. 

App developers who want to strengthen their product can see tremendous strides in utility, popularity, and benefit by strengthening the EHR integration capabilities of their app. Not only are there significant product weaknesses from failing to facilitate effective integration with Epic and other EHRs, but there are significant benefits from offering advanced levels of integration.

The Disadvantages of Not Integrating with EHR Workflow

Some degree of integration is better than no integration at all, as clinicians and non-clinician users do not have time to log into external websites while treating patients or determining the appropriate coding and documentation. Any degree of visibility is better than no visibility. However, data layer integration still offers significant drawbacks and inefficiencies that can negatively impact relationships between clinicians and their third-party app providers. These disadvantages include:

• Clinician and non-clinician users must click in and out of the different programs.
• Information does not copy over to the EHR.
• Clinicians and other users cannot receive prompts or recommendations based on inputs.
• EHRs remain disconnected, unorganized, and unintuitive to use.
• Third-party tools become under-utilized, leading to suboptimal patient outcomes, clinician burnout, and lost revenue for unused third-party health apps.

Three Different EHR Workflow Integration Options: Which One Is Best for Your App?

When third-party apps are effectively integrated with electronic health records, clinicians are better able to use the knowledge and resources provided through the external third-party web applications, including analytics for value-based care, risk-adjusted reimbursement, gaps in care, clinical documentation integrity, clinical surveillance, and other opportunities to improve clinical outcomes and financial results. 

This can empower clinicians and support them as they make decisions for patient care. However, the degree and specific pathway of integration make a significant difference in the experience and benefits. Consider these three integration options:

Integration #1: SMART on FHIR Launch

Rather than operating entirely outside of the EHR ecosystem, clinicians can access apps through SMART on FHIR buttons on the menu in the portal. This allows clinicians and non-clinicians to scroll through hundreds of different enabled apps, perusing the options to find which application has recommendations for the current decision they need to make in terms of treating patients or applying appropriate coding and documentation. 

While this method provides some degree of interaction within EHRs, it still creates notable barriers between what the app can provide and how clinicians can practically use it within the narrow time window of patient appointments or follow-up processes. 

Related: Transforming Healthcare by Empowering Clinicians with better EHR Workflow

The information and functions only materialize when the user intentionally navigates to the drop-down menu and finds the button for the exact application that has recommendations for improving care or appropriate reimbursement. 

The most applicable program for a given patient or collection of symptoms may be drowned out by the sheer multitude of buttons in the drop-down menu, or by the lack of time to find the drop-down menu and find the most button for the application with relevant recommendations. 

Rather than being directed to the app that’s the best fit for a given scenario, clinicians must guess or operate based on familiarity, simply clicking into likely options. Ultimately, this provides minimal improvement in usage or realization of benefits. 

Unfortunately, many third-party applications don’t have the bandwidth, capability, or expertise to move beyond this surface-level integration. 

Integration #2: Ribbons

Ribbons are another option for displaying recommendations from third-party applications. The ribbons may alert clinicians to key insights or provide popups directing users to relevant information sources. 

This provides display-only decision-making support and guidance on overall work processes to provide patient care. Users no longer have to independently search and open apps in pursuit of relevant information; the information is more readily presented. 

However, this option also offers only partial solutions. The information in the ribbons is not written into the Epic EHR. Instead, the burden falls to clinicians, who are already rushed and overwhelmed by the bulky, unintuitive records. 

They must manually write or copy and paste in the information they find most pertinent and manually navigate through decisions and next steps to type or paste data into the appropriate section of the EHR. Some of the drawbacks of this partial integration include:

• Users may enter partial information or even incorrect information. Rushed summaries that are vague or incomplete, misspelled words, and other errors accidentally transform helpful suggestions and insights into mistake-riddled records. Followup visits, appointments with referred specialists, and future invoicing tasks can also be negatively impacted as a result.
• The format itself is limiting. It ignores the more functional and intuitive forms possible, like badges, fill-in text recommendations, and other interactive components that better support decision-making and faster workflows. 

App developers that arrive at this level of EHR integration do offer some benefits for the clinicians who use the apps, the patients who receive better care from more comprehensive doctor-facing resources, and their own companies, which benefit from increased use and prominence. However, the gap between this level of integration and what third-party apps in other industries offer persists.

Integration #3: Decision Workflow

Decision workflow is an entirely different level of integration. Rather than offering read-only prompts and ribbons, health apps with decision workflow integrations become more substantively enmeshed in clinician and non-clinician workflows. 

Related: How EHR Workflows Impact Clinician Experience, Patient Care, and Profitability

As clinicians and non clinicians use EHRs, apps with this level of integration will generate notifications, badges, ribbons, side-bars and other form factors with data-driven recommendations for improving patient care and obtaining appropriate reimbursement. 

Clinicians and non-clinicians can select from recommendations in the form of radio buttons or similar automation and enter free text. Their selections are then written to the appropriate section of the EHR. This includes diagnosis codes and documentation.  

Key benefits of integrations that shape the workflow and support clinician decision-making include:

• Less stress and task-switching: Users don’t have to independently search for information or handle multiple tasks at once (talking to the patient, assessing the information, searching for detailed insights, completely required fields within the EHR, etc.). Instead, they can focus more on what the patient is saying and build a more authentic doctor-patient relationship.
• The risk of errors is significantly reduced: By eliminating manual data entry, third-party apps can automatically improve data integrity and quality of care. More than that, by putting up-to-date insights and prompts right at the clinicians’ fingertips, patients benefit from more modern and comprehensive information.
• A better return on investment for app development companies and provider organizations: Customers—the healthcare provider organizations that invest in apps—can prioritize patient care and relationships. Invoicing and billing information is more accurate, patient records are instantly updated, and there’s a better user experience from doctors. App developers also increase their revenue by becoming a more entrenched and vital part of healthcare workflow.

The more integrated your app becomes within the workflow clinicians and non-clinical workers follow, the more valuable it becomes. 

Elevate Your Health App with Effective EHR Integration Services 

Most healthcare apps have little to no integration with Epic or other EHRs. App companies have an opportunity to capitalize on this gap to improve outcomes for patients, doctors, and their own business goals. While there are different levels of integration possible, each one is superior to no integration at all, the gap between decision workflow integration and other more static, passive integration is clear. At Insiteflow, we offer a decision workflow interoperability SaaS platform that connects third-party apps with EHRs. Connect with us today to see how integration can instantly transform the experience of using your app.