Technology has revolutionized almost everything. From the way we consume music to how we engage in commerce, the entire experience has been dramatically transformed to make our lives better, more efficient, and in some instances to provide us with services that we could only have imagined just a few years ago. Consider how we currently use GPS in our cars versus how we navigated to our destinations just a decade or so ago. However, Healthcare Information Technology (HIT), and EHR in particular, has been one of the few industries that has not taken full advantage of the digital revolution.
Despite this, I believe that all is not lost. Although EHR solutions remain highly inefficient, I am convinced that many real, practical problems that couldn’t otherwise be solved in the analog world—such as identification of drug interactions, clinical-decision support, and machine learning to identify result-driven workflows—are now ripe to be addressed by digital technology.
Why now? The answer might surprise you—it can, at least partially, be credited to the meaningful use regulations. Don’t get me wrong, the negative unintended consequences of the MU programs have been well documented, from the inefficiencies and overhead burdens it has created for healthcare professionals, to the consolidation of the EHR industry, to the commoditization of EHR. There are plenty of cons to go around, but there are pros that, if leveraged properly, could form the foundation that the industry needs to achieve the ultimate goal of better outcomes and reasonable costs for everyone. What are some of these advantages? Patient charts are finally in some type of digital format, information sharing is beginning to be a reality, and interoperability among various systems is not just a buzzword that you read in articles and blog posts and hear at conferences—vendors are now allocating big dollars towards achieving it.
Make no mistake: healthcare professionals will always be at the center of the decision tree when it comes to how you and I are treated for medical issues, but leveraging advancements in computer science such as artificial intelligence (AI) and predictive algorithms can support more informed decision making. With AI, the abundance of data, and the right tools to analyze it, workflows can be better adapted to each professional’s specialty and needs, patients can engage in their healthcare, and treatment plans can be better optimized.
Today, many healthcare professionals hate their EHRs, and over 40% say that “EHRs interfere with the doctor-patient relationship.” It’s time we take on this issue. If providers, vendors, and patients join forces, we might be able to unleash the next generation of solutions and supercharge the healthcare digital revolution. I believe innovation is the just the cure we’ve been searching for!
What innovators are you looking for? What HIT innovation would you like to see?
As Thanksgiving nears, many of us are thinking about the people for whom we are truly grateful. This is also a great time to appreciate some of the life-changing innovations that we now take for granted – from music to medicine. We hope you enjoy this little trip down Memory Lane, and we hope you know how grateful we are to all of our clients, team members, and vendors who make up the SRS family!
What are you grateful for?
Today, we are used to searching for references for everything from restaurants and hotels, to clothing labels and wearable fitness technology. Whether you are planning a party or searching for a new physician, gathering a handful of reviews can help inform your selection.
Collecting EHR references is one of the most critical steps in the EHR search process. To ensure your reference gathering is as effective as possible, make sure several members of your staff are onboard. If each employee makes a few calls, the interview process will not require a large time commitment from any one of them.
Second, both administrative staff and physicians should call and speak to several of their peers at the reference sites to collect a variety of different perspectives and opinions.
Finally, don’t just call the references provided by the vendors—find other practices using the EHRs you are considering by joining professional society listservs such as MGMA’s and AAOE’s.
Once you’ve collected 10 references of similar size within your specialty from each EHR vendor—along with a few practices that weren’t provided by the vendors—ask each reference these 10 crucial questions:
- When did you install your current EHR?
- How long was the installation/implementation process?
- How would you describe the installation/implementation process?
- Was the system as easy to use as it appeared to be during the software demonstration?
- How has your patient volume changed?
- Approximately how much more time do you devote to entering exam data into your EHR as compared to how you documented exams before you began using this EHR?
- What percentage of your exam notes are fully-templated?
- Do you like the quality of the exam note generated by your current EHR? Does it represent you well?
- How have your patient interactions changed?
- Would you recommend your EHR to a similar practice?
Asking these questions will give you a clear indication of whether or not a specific vendor will be able to deliver the success you expect from your EHR implementation.
Keep this “cheat sheet” of reference questions handy throughout your EHR search process. It will prove invaluable and provide you with the information you need to save yourself from a potential mistake.
What are some additional questions you would ask of references?
Without These 5 Essentials Your EHR Experience Could Be Scary :O
Walk down almost any street on Halloween and you’ll be greeted by scores of people dressed in costumes. The outward appearance of these revelers is very different from what you find once the mask comes off. The same can happen when you see an EHR demonstration. There are so many things to focus on during the demo that you might be distracted from the most important points. Is it usable? Can it accommodate different workflow styles and data capture needs? And, can it be implemented without sacrificing practice-wide productivity? Although extras bells and whistles can make impressive costumes, they won’t guarantee EHR success.
How do you know if an EHR is a Trick or a Treat?
1. Things that go click, click, click in the night. The number of clicks it takes to perform basic functions—such as submitting electronic prescriptions, reviewing basic chart information, or documenting patient exams—is crucial when selecting an EHR system. If the system requires numerous clicks in order to navigate the software and enter clinical information during the patient encounter, and toggle back and forth between applications then the EHR will significantly decrease physician and practice productivity, negatively impacting both revenue generation and patient care.
2. The legend of one size fits all. The EHR should be flexible enough to serve your specialty, and your unique style of practicing medicine. Your EHR shouldn’t dictate your workflow, rather it should be flexible enough to accommodate many styles, and data capture goals. Knowing how, when, where, and by whom data is entered into the EHR is critical. If the EHR does not provide the flexibility to adapt to and help you improve your current process, then it may not be the right EHR for you.
3. Losing your way in a house of horrors. We’ve all heard EHR template horror stories about going through a long data input maze only to learn that you missed something and can’t escape without losing all of your work. Rather than suffering the same fate, ask references how flexible and easy the system is to use, and how many hours it took them to become confident with the system. If the other users quote an excessive number of training hours or your staff has trouble learning the software during a demonstration, the system is most likely not usable and therefore will be difficult to implement, and never be fully integrated into your practice.
4. Alternate realities. Other applications and office technologies should easily integrate into the EHR and be viewable within the same screen. There should be little to no toggling back and forth between application realities—it is inefficient, wastes time, and resources.
5. Recurring nightmares. Navigating, entering data, and generating reports in the EHR should be quick and easy. Diagnostic test results and transcriptions should automatically route into each patient’s digital record. Every paper process (or automated process if you currently have an EHR) that exists in your practice should be replaced by a superior automated process that frees up the physicians’ and staff’s time and allows them to focus their attention on patients.
Avoid these monsters—ensure all physicians and practice staff are included in the selection process—workflow, data requirement, and training time vary among the different departments and staff members. Remember, the EHR you purchase should enhance efficiency, workflow, and productivity throughout the practice. If it doesn’t, then it will not deliver all the benefits that “the right” EHR could bring to your practice. You might even consider your EHR a treat 😀
When I was growing up, Star Trek was the vision for the future of technology: intergalactic travel, teleportation, and tools that helped doctors heal instantaneously were portrayed as de rigueur. Here in 2015, technology has not quite caught up with the starship Enterprise crew—and while medical advancements since the sci-fi series’ 1966 launch date are extraordinary, there are modern-day tools that can hinder almost as much as they help. That’s science friction, and it can get in the way of the doctor-patient encounter. Is it possible to help physicians reap the benefits of HIT while maintaining the human nuances that define the art of medicine? We think so. That’s our mission at SRS.
We shared our Mission and Vision earlier this month at our annual User Summit, and we received such positive feedback from our clients that I thought I should share it here as well. I’ve been here just over a year, and I am so excited about what has happened during that time—and even more so about what we have planned for the not-too-distant future.
Our Mission is our PACT: Passion, Accountability, Collaboration, Transparency. Far more than just a clever acronym, these core values empower us to deliver on our mission to advance healthcare by providing HIT solutions that allow providers to deliver outstanding specialized patient care. Our Vision is to be the premier HIT solutions partner for specialty practices, and ultimately advance healthcare by introducing frictionless HIT solutions… constant commitment to our core values ensures that we preserve the individuality of specialty practices by designing and implementing innovative HIT solutions that support their unique goals.
Frictionless. This clarity of purpose is deeply routed in what we heard from our clients at last year’s User Summit. Specialty practices agreed with our guiding principles—improve practice productivity, demonstrate clinical quality, increase speed and value of reimbursements, and meet government regulations—but we heard their frustration about HIT getting in the way of their patient encounters. Patients need to be able to look their doctors in the eye—not stare at the back of their heads as they click away on a computer.
So we have adjusted our course. Now, protecting the doctor-patient relationship is our North Star, and our innovative team is literally developing the HIT solutions of the future. Of course, our commitment to productivity, quality, value, and meeting governmental regulations remains steadfast, but our technology will be adding value without subtracting it from the human side.
Those who attended the Innovation Expo at our User Summit got a sneak peek at things to come—and their reactions were otherworldly. We hope yours will be too.
Beam me up,
What’s your dream for the future?
I am not the first and will most certainly not be the last to discuss the shift from the fee-for-service model to the value-based model. Additionally, I do not claim to have any answers on where we will end up on the continuum between the two. What is obvious, however, is the fact that we need to begin looking at how we measure success today and how it will be measured tomorrow.
Most articles and studies today focus on large, complex health systems because they are at the forefront of the changes. Given the rocky start to programs like the 2-year-old CMS Pioneer ACO program—where 75% of participants failed to earn bonuses—the buzz on the shift to value is less than positive. So the question remains, how do we get ready for the shift and avoid the pitfalls seen by the health systems?
Change your KPI (Key Performance Indicator) perspective!
Practices today are very focused on cost reduction. As with any business, if you reduce unneeded costs, and maintain revenue, you increase profitability. Well, what if we translated that in the value-based world to Cost of Care? Imagine that you start this now and can soon prove that by reducing unneeded tests, prescribing generic drugs, and adding a rigorous pre- and post-surgery education program, your total Cost of Care is lower. This information could be used to gain bundled payment bonuses, not to mention the added benefits of cost reduction itself.
Other KPIs that should change are around patient access and engagement. Most practices have adopted the meaningful use benchmarks as their high-water mark for portal usage. However, we should change the conversation to true Patient Engagement. Rather than X% of providers sending a message to a patient or completing a VDT task (patients viewing, downloading or transmitting their clinical record), track the value added by your portal. Ask yourself if patients with a portal are more loyal? Do they add on more ancillary services that you provide? Do they refer more new patients to your practice? Do they have a better pre- and post-surgery experience? Aside from these more qualitative measure that can increase value, you can track cycle times for clinical and non-clinical processes, which directly impact costs to you in terms of staff time.
Last but not least is something that health systems already track but that can be adapted to the specialty ambulatory setting, Capture Rate. This is the portion of the patient’s total care that is captured by your practice. This means driving adoption of “other” services or simply grabbing market share. This KPI can be driven up by providing advanced access. This may mean having a percentage of the schedule open for on-demand access, or adding e-visits, or expanding hours. You can dovetail this with a portal to provide a more self-serve model. The concept here is that if you can provide more of the touch points in your practices, you can reduce costs along the continuum of care.
Experiment, Adjust, and Communicate.
Defining your KPIs is the first step towards creating a measurable improvement. While the ones above are some suggestions, your team may come up with more targeted KPIs based on your practice goals. A few quick tips as you go forward.
- Keep it simple – KPIs are not about data for the sake of data. Pick 1 or 2 and experiment.
- Be ready to pivot – We learn the most from mistakes and there is nothing wrong with changing course when you have more data.
- Consider both short- and long-term goals – Don’t try to jump to 100% value-based KPIs in 1 step.
- Communicate! – The biggest mistake you can make is not involving your entire organization. The full team must understand the end goal and then progress toward it. Nothing kills an initiative like the lack of a sense of ownership.
What are your teams doing to get ready for the shift to the value-based model? Do you have KPIs that you’d like to share?