The past decade of healthcare delivery has been dominated by the electronic health record (EHR), which has consumed vast hospital budgets and executive mindshare.
However, 35 percent of hospital executives say if they could go back in time, they would choose a different EHR vendor, and 56 percent say they seek out other health IT vendors to fulfill their needs rather than wait for their EMR to provide a tool.
These findings emerge in the Hospital Technology Forecast 2020, a new market report from Sage Growth Partners (SGP), a Baltimore-based healthcare research, strategy, and marketing firm.
Based on a survey of 100 hospital C-suite leaders conducted to gauge hospitals’ top health IT needs, challenges, and priorities, key findings from the market survey include:
Pessimism about EHR capabilities are pervasive; EHR loyalty is weak:
More than a quarter (27 percent) of respondents believe their EHR will fail to meet their future needs. COOs are the most pessimistic (67 percent) followed by CEOs (37 percent), and CFOs (34 percent).
If an organization’s EHR does not provide a tool they need, the majority (56 percent) of respondents say they seek out another vendor. Only 30 percent wait for the capability to be added to the EHR, and 14 percent say they create their own in-house solution.
The top three reasons executives look outside the EHR for an IT solution are: patient safety is jeopardized (No. 1), an outside solution promises greater ROI (No. 2), and an outside solution promises greater quality (No. 3).
Investment outside the EHR is already widespread, especially in non-clinical areas:
The top areas where hospitals have already invested in an IT solution outside of their EHR include data/analytics (73 percent), cybersecurity (70 percent), revenue cycle management (48 percent) and patient engagement (43 percent).
Of the health IT segments that hospitals have invested in, the areas of greatest return on investment include revenue cycle management and data/analytics (tied at No. 1), cybersecurity (No. 2), and operational efficiency (No. 3).
Over the next one to two years, hospitals’ top areas of health IT investment will include data/analytics (No. 1), operational efficiency (No. 2), patient engagement (No. 3), and revenue cycle (No. 4).
When asked to select the top digital health priority for their organization, most respondents (36 percent) selected patient self-scheduling. Just over a quarter (28 percent) selected care coordination; fewer selected patient access to clinical and financial records (15 percent), remote patient monitoring (12 percent), or disease management (nine percent).
With limited budget and attention, hospital leaders may choose the path of least resistance:
Sixty percent of C-suite leaders said only up to three percent of net patient revenue will be budgeted for new IT investments. Only four percent of C-suite leaders said more than five percent of net revenue will go toward new IT investments.
More than a quarter (28 percent) of survey respondents reported that vendors reach out to them daily, and another thirty percent field weekly inquiries.
A quarter of survey respondents said their EHR vendor offers rebates and incentives for adopting tools within the EHR. Of those respondents, 70 percent said this increases the likelihood that they would choose the EHR solution over a best-of-breed solution outside the EHR.
But executives expect any solution provider to keep up with interoperability requirements:
When asked how the recent CMS and ONC proposed rules on interoperability have affected IT investment plans, 48 percent said they simply expect their current vendors to provide solutions that meet the new rule requirements.
About one in five (22 percent) plan to hold off on investment decisions until they know more about the new rules, and 16 percent plan to accelerate investment. Only 13 percent reported already being in compliance with the new rules.
“The movement for new, better, and more appropriate digital solutions is underway,” says Dan D’Orazio, SGP’s CEO. “This is driven by fatigue and frustration around EHRs, as well as the many striking studies that show poorly performing EHRs can negatively impact patient safety. While hospitals were willing to put up with poor workflows in the EHR, they aren’t willing to compromise on safety, quality, or ROI. Healthcare is about to enter a new decade of digital innovation, and we will continue to see IT vendors and outside players like Amazon, Walmart, and CVS, disrupt EMRs and traditional care models.”
By Vladimir Kuzmenko, SVP of sales and business development, NIX United.
As healthcare becomes increasingly complex, the role of technology is evolving to offer new and innovative solutions that allow healthcare practices the opportunity to better serve their patients. However, as technology evolves and changes, healthcare as a whole must also grow and adapt to thrive in a complex and ever-changing ecosystem.
As we embark on a new decade (in which we’re now well into the first year), I’d like to examine a few of the more pressing trends that forward-thinking practices embracing currently and for the foreseeable future.
Some of these adoptions may include new systems and technologies being implemented, as well as technologies that are best-placed to keep up in these rapidly-changing areas of any profitable practice.
More importantly, however, is how these technologies might impact healthcare and how forward-thinking organizations take advantage of these opportunities. With this is mind, here are six trends that may influence healthcare in 2020 and beyond.
You may hear the term blockchain and think, “what does cryptocurrency have to do with helping patients?” However, blockchain has evolved and has many more applications than just new forms of currency. For instance, many urgent healthcare issues may be solved by utilizing blockchain, including:
Secure health information transfer
Health data management
Reducing the number of counterfeit medicines on the market
In addition, blockchain technology can be used in innovative ways to allow organizations to access information on a secure channel that maintains privacy.
Electronic health records
For all the integration issues U.S. healthcare organizations experienced in integrating electronic health records into their practices in the last decade, there has been no more profound change in the practice of healthcare in the U.S.
These electronic records create opportunities to track and improve patient care and to find new, more efficient treatment methods by incorporating artificial intelligence technologies. Protecting a practice’s and the patient’s data privacy is also an issue that must be addressed beforehand, not after a breach has occurred.
There is tremendous pressure on health systems to serve more patients, particularly as the need for services rises and insurance disbursements decrease. Adding new facilities to accommodate demand is often not a feasible option due to budgetary/capital constraints nor is adding more doctors with nowhere to put them. As a result, healthcare leaders consistently ask whether they are getting all that they can out of existing resources.
Operating rooms are a prime example. They serve as the economic backbone for health systems, and organizations need to maximize the use of OR capacity if they want to achieve their fiscal and patient access goals. Yet effectively managing OR blocks and scheduling in the face of volatile weekly demand patterns can feel like trying to squeeze blood from a stone.
If a significant portion of OR time has been reserved as dedicated blocks for surgeons or service lines, unless time not needed is released efficiently, ORs end up both not being used during business hours and yet working late into the night. Patients wait longer than necessary for scheduling procedures and organizations lose revenue.
Additionally, poor OR utilization makes it extremely difficult to accommodate the new surgeons that health systems want to attract. Current providers have a lock on ORs far in advance, regardless of whether they may need the time or not and/or later release these blocks. Such practices leave few opportunities for new surgeons to secure time when needed.
To remedy the situation, health systems are turning to data to look for insights into what can be done to improve OR utilization. After all, small changes in utilization translate to big differences in patient access, revenue and profitability.
The Role of EHRs
As data insights move to the forefront in organizational decision-making, there is some confusion about what EHR systems do and the role that they play. In a nutshell, EHRs tell you what’s already happened. They are vital systems, absolutely necessary for describing problems within organizations and supplying the data to back up assessments.
Breaking this down further, the purpose of implementing an EHR is threefold:
Reservation system: EHRs provide health systems a way to reserve resources, whether it be rooms, infusion chairs, or clinic time. EHRs do this as well as enable scheduling of specific equipment or providers.
Single source of truth for patient encounters: Organizations need a way to maintain records for every patient encounter — a single instance for each enterprise deployment — and EHRs provide this.
Descriptive reporting: Health systems require reporting. EHRs generate reports based on what was done, sort of like how Charles Schwab tells you how your portfolio performed.
While these functions are all essential to running a successful health system, there are several things EHRs are NOT designed to do no matter how much teams may wish they could. For example:
The electronic health record (EHR) industry continues to undergo a significant transformation, with many physicians asking themselves whether they consider their EHR a friend or a foe.
In too many cases, medical staff feel their EHR works against them, not for them. In fact, according to Medical Economics’ 2019 EHR score report, 60% of physicians said their current EHR system was harming their ability to engage with patients. In addition, The National Academy of Medicine found that as many as half of American physicians and nurses experience substantial symptoms of burnout. And, the same study found that poorly designed technology is a major contributing factor due to the increased amount of time needed to keep systems properly updated.
This should not be the case, and it’s time to change this narrative.
As we near a new year and a new decade, it’s time to focus on advancing EHRs to make the lives of physicians easier, while assisting in improving the patient experience, increasing engagement, enhancing administrative burdens, and more.
Required features and functionalities of EHRs in the next decade include:
Legacy EHR’s are typically thought of as outdated and lacking customization. Custom forms take months to build, cost extra and users ultimately lack control over the functionality. This is not acceptable by today’s standards. Every healthcare practice and specialty is different. So, the EHR must be customizable to fit each practices’ needs in order to optimize efficiency in data entry and management.
In addition, medical trends and challenges are constantly evolving. For example, opioid addiction has risen to epidemic levels in the United States, with the Centers for Disease Control and Prevention (CDC) estimating that more than 130 people die from an opioid overdose every day. Fortunately, health information technology has emerged as a powerful tool for tracking prescription activity.
EHR’s hold a tremendous amount of data – data that can help physicians provide better care to a specific patient or population. Armed with these analytics, a practice can gain insight into population health — along with reporting requirements for government incentive programs and data to optimize billing and cash flow.
The EHR of the next decade should be a tool for decision making. EHRs need to utilize advanced artificial intelligence (AI) and machine learning to make smart suggestions based on data.
An EHR should not just track if a patient is following their care plan, but alert providers when a patient has missed certain critical elements and make suggestions on how best to proceed. As such, the technology can be used to play a larger role in lowering no-show rates and helping predict which patients will have the most success – or biggest challenges – with certain treatment plans.
EHR’s should also be capable of helping physicians make the best financial decisions for their practices. In addition to increasing practice efficiencies and costs, EHRs assist in offering reduced drug and treatment plans with expected costs.
Although electronic health records (EHR) are firmly established in the medical landscape, ongoing progress necessitates that providers keep up with emerging trends. Here are five of them.
1. Combining Artificial Intelligence and Voice Recognition with EHR
Artificial intelligence (AI) has already shown promise for assisting doctors with making diagnoses or recognizing historical trends about a patient’s condition. However, several companies are investigating bringing AI to EHR via voice recognition capabilities.
At Vanderbilt University Medical Center, providers can query the tools by posing questions in natural language. For example, a physician could ask a voice-enabled EHR system for details about a patient’s last recorded iron levels from blood tests. The system would inform the doctor of those levels, plus tell them whether they’re in a healthy range.
Allscripts and Northwell Health also recently struck a deal for a platform that blends AI with EHR and collects data from clinicians. Using voice commands within patient care could be especially useful for providers who have their hands full.
2. An Increased Emphasis on Mitigating EHR Errors
When the ECRI Institute released its 2020 report containing the top 10 health technology errors to be aware of in the coming year, EHR issues were mentioned multiple times. The first instance related to providers potentially being overwhelmed with notifications from EHR platforms, ignoring some of them and perhaps overlooking a genuine issue with a patient as a result.
The report also brought up the risk of medical data not including information about implants in patients that are sent for medical imaging. The study recommended providing a single place to enter or check for the presence of implant data in an EHR. Finally, the ECRI Institute cautioned that EHR mistakes could happen when a medication administration order sent by an EHR platform does not match the dosage time the provider intended.
This coverage of such mistakes will likely cause health care facilities to assess their systems and see if the issues exist there. If so, they’ll look for ways to reduce those problems.
Senior living communities depend on human connection and care that serves each resident’s individual needs. But too often, a paper charting system gives way to inefficiencies such as medication mistakes, poor compliance, revenue leaks, and overall headaches for staff and administrators. As a result, senior living communities that rely on paper charts can’t always deliver the level of care they want to provide their residents. This can lead to dissatisfaction among residents.
And if residents are unhappy, community executives are unhappy.
That’s where electronic health records (EHR) come in. They eliminate the pain points of a manual documentation system and make it easier for staff and administrators to focus on the “why” of caring for residents by streamlining the “how.”
Here’s a look at the four main ways EHRs strengthen operational efficiency in senior living communities and enable excellent care for residents.
EHRs Improve Communications and Transparency
Senior living care hinges upon having access to accurate, up-to-date information about a resident’s health. For CNAs to deliver that care to residents, they need to communicate critical information smoothly and in a timely manner.
With a paper documentation system, it’s too easy for important details to get lost in the constant shuffle of folders and paperwork. Poor handwriting can cause confusion. If residents have incomplete clinical profiles, CNAs’ jobs are harder – there’s lots of back-and-forth with other CNAs and digging through file cabinets to find the information they’re looking for.
Compare that with EHRs: CNAs can use EHRs to efficiently record and access information about a resident’s health in real time, on cell phones, tablets, or computers. This information means CNAs can trust the EHR to correctly answer questions about a resident’s medication doses and clinical history.
Plus, long-term record keeping is critical in a senior living community with high staff turnover. EHRs make it easier to onboard new CNAs and help them quickly get acquainted with individual residents’ profiles.
But staff aren’t the only ones who benefit from enhanced communication through EHRs. A centralized and digitized record of contacts invites everyone to the conversation about a resident’s health.
If a resident visits the hospital, medical professionals can forward a hospital intelligence report to anticipate changes to resident services. This elevated communication between senior living communities and hospitals can improve health outcomes – research from the National Institutes of Health shows that EHR use in hospitals decreases readmission rates.
Family members at home want to stay in the loop on their loved ones’ health, too. EHRs can integrate clinical information into senior living family communication portals. That way, family members don’t just hear during visits or after an emergency – they can check in on their loved one’s health as often they please.
Like so many industries in today’s Third Industrial Revolution, the pace of innovation in healthcare today is fast and ever-changing. New technologies – like artificial intelligence (AI), machine learning, big data, the Internet of Things (IoT) and voice recognition – are at the heart of applications and tools that are becoming demanded by patients and more ingrained in clinicians’ daily workflows.
For vendors developing new solutions based on these technologies, it appears they find themselves in a ‘race,’ striving to be first-to-market in order to establish their competitive edge. But being on the bleeding edge of innovation isn’t always easy. The healthcare industry has not been immune to this rapid quest for first-mover advantage. Often when this occurs, these new solutions sacrifice the quality and functionality required to deliver on promised improvements.
Think about the initial introduction of the electronic health record (EHR). Billed as a way to make practices and physicians more efficient, many early EHR solutions had the opposite effect – creating a significant learning curve and adding to physicians’ workloads overall. While EHRs may have made great strides toward digitizing medical records, taking paper and manual processes out of the equation, they often created new problems that placed different burdens on practices, providers and patients. In fact, in the early days, physicians reported spending more than half of their workday – an average of six hours – using the EHR, plus another 86 minutes after hours.
But EHRs are not the only healthcare technology solution attributing to this challenge – it transcends innovation across the entire health IT sector. As an industry, we must take a step back and slowdown to ensure all new technology can deliver meaningful change to practices, providers and patients.
How to Design New Healthcare Technology with the End-User in Mind
A key to ensuring healthcare technology delivers true benefits is considering how it will fit into day-to-day operations of the end-user – whether that be a patient, a nurse, a surgeon or a billing manager. Before introducing any new technology to the market, make sure your first intention is to get it right.
To do that, engineering teams must employ “user-centered design,” a concept that emerged in the mid-1980s. This approach, defined by the International Standards Organization, “aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, usability knowledge and techniques.” The goal ultimately is to enhance effectiveness and efficiency, improve human well-being, user satisfaction, accessibility and sustainability, and to counteract possible adverse effects of use on human health, safety and performance.
User-centered design in healthcare could entail shadowing a nurse to observe his workflow when triaging patients, following a surgeon to see how she develops post-op papers, or interviewing patients to understand how they obtain healthcare information in their daily lives.
With that experience, you can then ascertain what capabilities would make users’ lives easier or more effective. From there, determine if there’s a way to improve an existing product on the market to fulfill needs, or whether a completely new platform is required.
Key Questions to Answer When Implementing a User-Centered Design Approach
There are several questions you must consider when following this method:
By Aaron Perreira, director of integrated marketing, Kareo.
Over 70% of independent medical practices agree that the time demands of electronic health records (EHR) data entry detracts from care delivery. Simultaneously, 69% of independent practices state that integrated technology solutions are needed to improve the efficiency and profitability of their practices. This interesting “love/hate” relationship between independent practitioners and technology was shared in the recent 2019 State of the Independent Practice Industry Report, published by Kareo, a cloud-based medical software company.
The report was based on a nationwide survey designed to uncover the current challenges and expectations of independent practitioners in several areas of their practices, including care delivery, billing, patient engagement and regulatory compliance. Attitudes regarding the role of technology emerged in each of the areas surveyed.
Providers are increasingly reliant on their EHRs to manage their day-to-day clinical operations and maintain regulatory compliance. For many practices, the use of EHRs began when the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was signed into law by President Obama on February 17, 2009. The HITECH Act was created to motivate the implementation of electronic health records by providing monetary incentives for being able to demonstrate meaningful use of electronic health records.
At that time, the market was flooded with more than 700 EHR vendors looking to capitalize on the EHR gold rush. Many practices adopted EHRs at that time, however since then, as the regulatory standards and consumer requirements for EHR technology continued to evolve, an increasing number of software providers have failed to keep up with technology and have fallen out of the race. This has left many providers tethered to antiquated, ineffective systems. More established practices (in practice for 10 or more years) appear to be more gun shy in that they likely adopted their EHR several years ago and had to suffer through poor implementations of costly but under-performing software that didn’t deliver on the value that was promised.
Despite government mandate, penalties and incentives, only 64% of respondents are currently using an EHR today. This low figure likely represents both the entry of newer practices that haven’t yet implemented their EHR platform and the fact that some practice specialties such as mental health, are more likely to still be using paper-based records and haven’t made the switch to electronic records.
Over the last few years, hospitals and healthcare practices throughout the country have started adopting new technology that helps them provide better care to their patients and make life easier for their employees.
For example, 64 percent of physicians now send electronic messages to their patients via text or email. Meanwhile, 63 percent allow their patients to view their medical records online.
Are you looking for new ways to bring your practice into the 21st Century? Listed below are seven of the top healthcare technology trends you ought to know about and consider implementing in your practice.
Electronic Medical Records
Electronic medical records (or EMR for short) are one of the most popular tech trends in the healthcare world.
Lots of practices have started using EMR to simplify the process of searching for patient records. EMR has also made it easier for patients to access their medical records online.
Even though plenty of practices are making use of EMR, there are still a lot of them that haven’t made the switch yet. The sooner you start making your files available in a digital format, the sooner you’ll start reaping all the benefits of EMR.
For example, EMR provides immediate access to patient records. It also helps physicians make better decisions about their patient’s care.
They can spot patterns more easily when everything is in front of them. This, in turn, allows them to choose the best treatment approach and avoid missing something important.
Blockchain has started to make its way into the healthcare world, and it’s not showing any signs of leaving.
Blockchain technology allows healthcare practices (and other businesses, for that matter) to store digital information without taking up a ton of space. It also allows them to store their information in a more secure way since it cannot be copied.
In the digital age, patient security and privacy protection are of the utmost importance to many healthcare professionals.
Blockchain systems allow practice owners and managers to ensure they’re keeping patient records and information safe. It also helps them to avoid expensive and harmful (on many levels) data breaches.
In 2019, many people are looking for new ways to get things done without leaving their homes. They have groceries delivered to their door, for example, and they communicate with friends and family via video chat.
Lots of healthcare practices are jumping in on this trend and are making it easier for patients to have their medical needs met from the comfort of their own homes as well.
Telemedicine allows patients to talk to doctors, receive medical advice, and even have prescriptions filled, without having to make a special trip to the doctor’s office.
Physicians are also using these same technologies to communicate with each other in more effective ways and come up with better, more comprehensive solutions for their patients.
Artificial intelligence is for way more than gaming. It’s also one of the biggest healthcare trends of 2019.
Physicians and researchers have started or have plans to start using artificial intelligence in a variety of ways.
As artificial intelligence technology becomes more refined, it will be easier for healthcare professionals to monitor their patients and provide better diagnosis and treatment.
It will also likely enhance the telemedicine world as well, as it will make it easier for physicians to see their patients without having to be in the same physical location as them.
Wearable health monitoring devices are not new. However, they’ve become more popular than ever, and they’re also becoming more advanced.
As these devices become more accurate and able to provide more details about the wearer’s health, it’s likely that many physicians will start relying on them to gather information about their patient’s health and daily habits.
As provider adoption of electronic health records (EHRs) approaches near-universal levels, a study from The Doctors Company shows the frequency of claims in which EHRs contributed to injury continues to rise.
Analyzing EHR-related medical malpractice claims that closed between 2010 and 2018, The Doctors Company uncovered that the pace of these claims tripled, growing from a mere seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018.
While EHRs are not often the primary cause of claims, the study shines a light on potential risks they may pose in care delivery, as well as the top factors that contributed to the claims. The study showed that EHR-related claims were caused by either system technology and design issues or by user-related issues. Among the top findings:
Top user-related issues stem from incorrect information, pre-populating or copying and pasting, and hybrid health records or EHR conversion.
Top system technology and design issues were problems with electronic systems and technology failure.
Of those injuries that occurred in 7 percent or more of claims, adverse reaction to a medication and death were by far the most prevalent.
Diagnosis-related allegations represented nearly one-third of the total.
Two specialties—family medicine and internal medicine—received the highest percentage of claims where EHRs are a factor, followed by cardiology and radiology.
Based on this data, study author Darrell Ranum, JD, CPHRM, vice president of patient safety and risk management at The Doctors Company, identified the following steps to prevent EHR-related risks that may ultimately contribute to an adverse event: