In what appears to be an extension of yesterday’s post, today I want to examine some questions posed by Success EHS, which asks, “Should you replace your EHR?”
As you most likely know, most large enterprise ambulatory practices and hospital systems have well-established EHR systems in place. They are clearly recognized as among the early adopters of electronic health records, and, compared to their small counterparts, are also the most likely healthcare facilities to currently be in the market for an alternative EHR.
In the age of meaningful use, in a time where healthcare technology is also known as the electronic health record, the systems are being replaced with great frequency. The why and what fors are pretty simple to figure out if you’re familiar with the technology and the marketplace.
There are several prevailing reasons practices are jumping systems, though. They include (and I’m citing Success EHS here):
• Lack of strong vendor support
• Lagging product development
• Consolidation of disparate solutions
• Systems fail to live up to vendors claims
• EHR hinders efficiency and productivity
Given these hurdles – there may be others, of course – there are several questions practice administration must ask to determine whether it’s time to move.
Some of these questions include (feel free to grab a pen and paper and add to the list):
• Are issues able to be solved through remediation? No? Might be time to hit the road.
• Can the vendor’s technical improvements resolve any issues? If so, you need to ask that fixes be made in a reasonable timeframe. Obviously, telling said vendor that fixes need to be made “ASAP” won’t do; you must be reasonable. Consider negotiating a term of three to six months and get final terms in writing. Anything more than six months and it might be time to pack up and leave.
• Are you partially responsible for the EHR’s issues? If you’re partially or fully at fault for a botched EHR implementation or for poor usage, you owe it to yourself, your staff, your patients and, yes, to your vendor to work out a solution. If you’ve tried every solution and there’s no fix, you may be forced to move on. Some times it’s a matter of agreeing to disagree, let’s just agree on that.
• Do you have an opt-out clause? If so, you may wish to exercise it. If not, you’re going to pay, probably handsomely, to exit stage right.
• Are your current long-term goals going to be met using your current EHR? If not, you need to change your goals or change your system.
• Is your EHR negatively impacting practice efficiency? Success EMS says it best, “An EHR that hampers productivity now will only grow worse as the complexities of health reform initiatives increase in the future.”
If you decide it’s time to implement a new EHR system then it’s time to create an assessment plan. Assessments are designed to answer the “why” of implementing an EHR, and what is working and can be improved by installing one.
You can learn more about those here: Assess Your Practice’s EHR Readinesss and Plan Your Implementation.
If physicians use healthcare technology so much less than practice administrators and others in the average practice with these implemented systems, why do they continue to receive so much of the marketing and pre-sales attention from vendors and others in HIT community?
All healthcare vendors take a similar approach with physicians as they jostle for a lane at the front of the race. They gear their public-facing collateral and educational materials to physicians knowing all the while that they also must woo practice administrators and support staff. Rarely, though, is there any effort put into publicly promoting healthcare technology systems to non-physicians nor is there much effort behind celebrating non-physician care givers and administrators as the industry’s leading users of HIT.
It should come as no surprise that non-physician practice employees, such as RNs and PAs, use the systems like electronic health records, much more than their physician counterparts, on average. But, for whatever reason, HIT messaging is all about the physician and continues to be tailored to these mascots and figureheads within practices and healthcare settings.
EHR Watch’s editor, Jeff Rowe, recently published a blog post about the amount of time physicians use healthcare technology as opposed to their in-practice colleagues like RNs and PAs.
In his succinct summation PAs and RNs spend more time online for professional purposes than physicians; during consultations, PAs and RNs leverage mobile applications more at the point of care than physicians; and, in his words, “PAs and RNs use pharma or biotech websites more frequently than physicians and are more interested in using pharma features on electronic health record systems (EHRs).”
If physicians spend most of their time seeing patients and administering care, there’s nothing shocking about this data. It’s a good thing; they need to be seeing patients, not playing around on their computers.
However, this information should validate what everyone in healthcare already knows: Physicians are not the only ones using healthcare technology, and more can be done to include healthcare’s other care providers (and leaders) in the conversation about the technology and how it affects business and patient care outcomes.
The data Rowe provides also should encourage practices to continue including non-physician team members in the selection process of new technology if they are not already doing so because, clearly, though physicians are experts in providing care, they are not always the experts in using a practice’s technology solutions.
The Olympics always inspire me. They are one of most fantastic human events to witness, including the obvious sportsmanship; athletes overcoming obstacles; the sheer passion displayed by those competing in the field; the pain and joy of the athletes; shots of their family’s responses to the competition; and the personal stories and exposition about overcoming the odds.
Despite the haul of medals taken by the likes of swimmers Michael Phelps and Missy Franklin, the U.S. women’s gold in gymnastics and Serena Williams in tennis, other Olympic contributors will leave London without any hardware, but perhaps having just as much impact.
Healthcare technology continues to invade nearly every aspect of life, and the Olympics are not immune. One of the most notable appearances of HIT in the games has been by GE Healthcare. Actually, from my recollection, GE has been the only game in town during the greatest human competition on the planet.
What GE has done so well during the games is connect its products with consumers. Through a series of informative commercials, those of us on the sidelines have been able to learn how GE’s systems help keep the games clean, how they help identify and localize athletes’ injuries and potentially help treat injuries more quickly, and finally, how the systems actually help us in our lives anywhere we may be.
For example, we are also able to see how GE’s healthcare technology is being used to change lives, as is the case of its commercial about the technology serving an East London hospital’s pediatrics unit.
The stories featured in GE’s commercials are compelling for a couple of reasons, primarily because GE is the only technology vendor talking about how its products change the lives of real patients, but also because GE is taking the healthcare technology conversation to people who never would have otherwise engaged or thought about technology in healthcare without the commercials.
Consumers are not often engaged in conversations about the benefits of the machines and software they encounter during trips to the hospital or while meeting an iPad screen in their physician’s office.
Most patients have no idea what the letters “EHR” stand for. Those of us in healthcare technology seem to forget that; we pollute our own well, if you will. We get so enamored with the industry, its terms, its regulations and its advancements that we forget there is a whole world out there, that we eventually must try to sell to, that doesn’t know the first thing about technology or its purpose in healthcare.
Prior to my joining the EHR vendor space, I only knew things like, “That big tube thingy take pictures of my insides,” and “The jumping green line on the electronic graph means my heart works …”
But, those of us in the HIT community like to talk technology, and if we can’t find someone in the real world to listen, we talk to ourselves, which brings me back to GE.
If for no other reason than to educate consumers of the importance of healthcare technology and how it can impact something as mainstream as the Olympics, the company at least brought the conversation to the public and met consumers in their world rather than simply ignoring it like so many others, and that’s admirable.
The numbers don’t lie. The meaningful use incentive program is working, at least as far as awarding stimulus funds is concerned. The incentive program awarded “761 hospitals and 56,585 professionals a total of approximately $2.3 billion for 2011; $1.3 billion to hospitals and $1 billion to eligible professionals,” according to Healthcare IT News.
The median payment to hospitals was $1.7 million. According to the same publication, in a recent interview with National Coordinator for Health Information Technology, Farzad Mostashari, his top concern is how hospitals and practices embrace the spirit of the rule and use their technology to successfully engage patients.
From dollars to sense. Without patient engagement, meaningful use is meaningless. Without applying the patient information to the population served and working to improve outcomes and offering education and guidance – perhaps creating support groups for smokers wanting to quit or practice-sponsored nutrition plans for obese and diabetic populations – to patients, meaningful use is nothing more than a government-run plan to collect information about its citizen’s health.
Incentives aside, healthcare providers should wish to do no harm and use the information available to fully commit to embracing change through the technology and data available and do what they do best: care for and help provide health education to their patients, their customers.
In other words, to borrow a line from Mostashari, “If you treat meaningful use as work, you won’t get much out of it.”