Tag: health IT

Aug 14
2012

Should You Replace Your EHR?

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.

Related

Aug 9
2012

EHRs Interfere with Patient Care? Some Physicians Say So

Does healthcare technology actually interfere with patient care? Apparently so, according to a new study commissioned by athenahealth.

“Overburdened” physicians face pressures from continual government “intervention,” “increased use of and frustration with EHRs” and “administrative burdens.”

According to the study, physicians are disenfranchised.

Why? Well, according to athena’s study, there’s too much change. Perhaps that’s a bit of a blunt summation, but it seems to be the picture the study paints.

Nearly half the physicians interviewed for the study said electronic health records were not designed with the physician in mind while nearly two-thirds said the EHRs take away from their ability to engage with patients.

Some of this is obviously subjective opinion. Of course, there’s really no way to measure whether or not patients feel put off by their doctors entering data during the visit. On the contrary, there are plenty of reports to suggest that patients actually appreciate that doctors use an EHR during the visit.

However, from the eye of the beholder (physicians), they’re the ones sitting in the practice day after day getting a feel for the moods of their patients in the exam room once the keyboard comes out.

Sadly, the conclusion they have come to as a collective population is that EHRs are significantly reducing the quality of care patients receive. Again, this is filled with opinion, but if it’s the mood conveyed, that mood is bound to rub off on the patient population and will affect their perception of the technology, too.

These same physicians – more than 80 percent of physicians in the study – also feel the future of the independent practice is not viable, and more than two thirds feel the quality of care will greatly diminish over the next five years because of all these continuous distractions, including technology’s pervasiveness in the practice space.

This is stark “reality” for the profession from the mouths of its professionals.

Interestingly, in a completely unrelated study by recruiting firm Jackson Healthcare, more than a third of private practitioners say they will quit private practice within the next 10 years because of “declining reimbursement, capitation, and unprofitable practice; business complexities and hassles; overhead and cost of doing business too high.”

Where they’ll likely end up is obvious: in a hospital setting or in a hospital-owned practice. Why leave? They said they fear economic factors facing private practice (the first reason given) and they don’t want to practice in the age of reform (second response), which may be quite difficult given the current climate of healthcare.

What does all of this eye-opening information mean?

Well, it doesn’t bode well for those concerned about the ever increasing shortage of healthcare providers.

Perhaps more troublesome, though, is that no matter how much time is spent educating and informing certain segments of the healthcare population, there are always going to be many who remain unconvinced that technology produces practice efficiencies and helps lead to better care outcomes.