Electronic health records (EHRs) are being implemented at an increasing rate, with 59% of Medicare eligible office-based physicians and 94% of non-federal acute care hospitals attested to having a certified EHR platform, according to the Office of the National Coordinator report in 2013. Healthcare providers are facing significant economic pressures just as they emerge from large scale EHR implementations due to Healthcare Reform’s continued stress on reimbursement rates, increased focus on quality, and access to care. To be successful, providers need to place greater emphasis on realizing value from EHRs to navigate the challenges of Healthcare Reform and make progress in improving the quality of care.
EHRs provide a variety of opportunities to address quality, access, and cost challenges through functionality such as clinical documentation, interoperability, patient portals, physician order entry, and revenue cycle management, yet implementing all these changes requires a significant organizational investment. Many organizations are evaluating how to allocate limited IT resources for supporting EHR initiatives, while recent industry surveys show that many healthcare executives have not developed measures related to a clear return on investment (ROI) from EHR use. Additionally, lack of a defined post-implementation strategy for ensuring benefits realization and ineffective governance structures result in most organizations not realizing value from using their EHR. Industry experts from the Institute of Medicine’s Roundtable on Science and Value Driven Healthcare have made some progress in addressing this issue by publishing a standard model for assessing institutional return on EHRs. Despite this model holding promise to assist in measuring the various cost and benefit variables associated with EHR use, further discussions are required before it can be more widely used.
Through an EHR implementation, organizations can successfully digitize the capture and storage of their patient data across the continuum of care. The next step is leveraging EHR data to drive strategic decisions and improve quality of care for patients. Investments in analytics and predictive modeling can help in identifying at-risk patient populations and measuring outcomes of clinical procedures. Integrating patient information such as clinical notes, results, and medication history from various care settings will allow clinical decisions based on a comprehensive view of the patient’s health. Greater visibility into patient information facilitates the development and implementation of evidenced-based medicine protocols. Capabilities that inform the physician, monitor adherence, and measure outcomes of evidence-based medicine practices not only improves care for the patient but also reduces waste in the treatment process. Turning data into actionable insight for the clinician is an important component in developing future care delivery models for the organization.
EHRs offer new ways of working through digitized processes that can transform clinical operations and improve operational efficiency. To institutionalize these changes and achieve desired results, an organization should outline its future operating model with inputs from both clinical and business leadership. Once the future state operating model is defined, an actionable roadmap with definitive measures can be developed. By executing against this roadmap, detailed operating processes can be implemented along with necessary changes in organizational structure and supporting technology.
Addressing post-implementation challenges will demand increased attention from healthcare executives as the industry continues its widespread adoption of technology. Industry leaders have agreed EHRs are a vital IT tool to enable “bending the cost curve” through improvements in care quality and reductions in cost. However, realizing and measuring these benefits will vary for each organization because of their unique culture and operating environment. Standard “out of box” implementation and operation of an EHR is not sufficient to realize optimal value. The healthcare landscape is shifting rapidly, post-implementation strategy can no longer be an afterthought and is instead a key challenge in today’s operating environment. As the healthcare sector increases focus on providing cost efficient, accessible, and quality based care, each healthcare provider organization must develop a strategy to align EHR capabilities with business goals.