Acceptance of electronic health records since the year 2009 has been quick and pervasive in the healthcare industry. Utilizing meaningful use as a barometer, 95% of all eligible hospitals and 54% of office-deployed physicians have installed the networks to an extent enough to qualify for incentive funding under the federal EHR Incentive Program.
But there is mixed views on whether those networks have delivered actual value. Much depends on the measuring stick that researchers hold against electronic health records.
For instance, the capability to derive value from the networks has been restricted by ease of use problems, contends the American Medical Association. The national professional association for physicians is becoming more vocal in its message that the very incentives proposed to drive widespread acceptance of EHRs have exacerbated and, in some examples, straightly caused usability challenges.
Meanwhile, a survey of healthcare agencies with a track record of EHR contribution and expertise report that their executives are agreed that they are acquiring a return on their electronic investment. Still, those similar executives report deficiency of satisfaction with the networks among nurses and physicians, which restricts the value the EHRs could deliver to their agencies.
Answering the query of value will become even more crucial, as healthcare agencies sustain to invest time, effort and finances in installing and optimizing their utilization of clinical systems. Acquiring value, in terms of return on investment, will be necessary in coping with value-based care models.
The survey of hospitals with “greatly sophisticated EHR systems” by the Healthcare Information and Management Systems Society (HIMSS) discovered that the profits of using EHRs for these institutions far outweigh any of the perceived pitfalls, researchers summarized.
The 2016 HIMSS Value of Health IT Survey discovered that 88% of healthcare agencies with advanced EHR settings identified at least 1 positive outcome from their utilization of an EHR. Some 83% reported increased efficiencies in their respective clinical staff’s quality performance. Additionally, 81% demonstrated that their agency documented at least 1 positive influence in acquiring savings.
Still, challenges exist. Only 44% of respondents from these agencies reported that the EHR systems increased nurses’ satisfaction, and only 29% reported increased satisfaction among physicians. Researchers attributed the staff satisfaction outcomes to the “important disruptiveness the EHR has for clinicians.”
Because the 52 executives surveyed by HIMSS depict an elite group of healthcare agencies—entire HIMSS Analytics EMRAM Stage 6, Stage 7 and Davies Award winning hospitals—the outcomes are not surprising, in accordance to Sarah Corley, chief medical officer of vendor NextGen Healthcare and vice chair of the Electronic Health Records Association.
“One would hope these findings, since entire respondents are high-performing organizations,” Corley states. “We find the survey is a valid depiction of the experiences of this subset of users. Although, this is not going to represent the broad experience of the market, because most agencies are not at this level of sophistication. It does, however, indicate that with concentration and attention to optimizing health IT deployment, agencies should hope to see value, as experienced by this cohort.”
But the experience of some high-performing agencies in the HIMSS survey does not depict the fact that most contributors are struggling to acquire value from costly IT investments, critics argue. The AMA has raised its posture nationally to express members’ requirements for more usable networks that give value in their clinical practices.
“Most electronic health record systems fail to support efficient and effective clinical work," argues AMA President Steven J. Stack, MD. “This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.”
At the similar time, while the utilization of EHRs in healthcare is near ubiquitous, the industry still suffers from a deficiency of interoperability between these networks. For instance, merely about 40% of hospitals nationwide routinely have electronic approach to essential clinical data from outside contributors or sources when treating a sufferer, in accordance to the Office of the National Coordinator for Health IT.
And, however EHRs have the potential to decrease medical errors and adverse events, contributors have observed a range of unintended consequences that actually launch new areas of risk, involving the misidentification of patient records.
“Sufferers receive care in various different healthcare settings, and these settings are often unconnected,” states Tejal Gandhi, MD, president and CEO of the National Patient Safety Foundation. “Our system is presently too fragmented to make certain that all of the data gathered in each setting gets reported, recorded, and dealt where it should.”
Still, HIMSS researchers and the advanced EHR agencies that engaged in the recent survey say their experiences should motivate others in the industry to persevere and anticipate acquiring eventual value for their attempts.
Lorren Pettit, vice president of research for HIMSS, calls these comtributors the EHR “pioneers” who are “seeing what the land ahead looks like for others and are reporting back.” These leading agencies are documenting the profits of EHRs in clinical settings, he considers, and there is much that can be learned from them.
Case in point: HealthNet, Indiana’s greatest federally qualified health center, which was named a 2015 HIMSS Ambulatory Davies Award recipient. With the help of an EHR and a variation of IT interventions, HealthNet has decreased low birthweights, make better care outcomes for pediatric patients, and importantly increased patient satisfaction. Additionally, the utilization of the EHR system from eClinicalWorks improved sufferer management and billing, which has produced a 230% return on investment since the year 2009.
“We never had the capability before to track these types of data elements,” asserts Donald Trainor, MD, chief medical officer at HealthNet, who has led the agency through its EHR execution across nearly 40 locations. “We can really run reports that look at our complete universe of 60,000 active sufferers and measure quality results.”
Most EHR systems fail to support efficient and effective clinical work.
HealthNet’s experience speaks straightly to the value discussion, states Eric Helsher, vice president of client success for Epic, one of the country’s greatest EHR vendors. Optimized use of such networks enable health systems to continually pick particular clinical improvement or cost-reduction objectives and acquire them. “Health systems we work with have decreased infections, averted diabetes-related amputations, increased depression screening, and gave better and less costly care by remotely monitoring sufferers in the hospital or at home,” Helsher claims.
Centura Health, which manages sixteen hospitals in Colorado and Kansas, has derived value from its implementation by acquiring an important reduction in medication errors through using its hospital and ambulatory EHR system from MEDITECH. Additionally, the 2015 HIMSS Enterprise Davies Award winner used its systems to lessen hospital readmissions for sufferers with chronic conditions.
"Spread out as we are with sixteen hospitals, trying to do this without EHR technology would be impossible,” states Dana Moore, senior vice president of information technology at Centura. “What having a better EHR does is it offers a foundation to construct upon to find those problem areas and to initiate solving them.”
Although, Pettit appreciates there is a “learning curve” for realizing these types of clinical efficiencies. “It is not a slam dunk. You do not just slap in the EHR and then tomorrow you see profits,” he summarizes.
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