Why We Store Data in an EHR

Shereese Maynard offered this interesting stat about the data inside an EHR and how that data is used.

I then made up this statistic which isn’t validated, but I believe is directionally accurate:

Colin Hung then validated my tweet with his comment:

It’s a tricky world we live in, but the above discussion is not surprising. EHRs were created to make an office more efficient (many have largely failed at that goal) and to help a practice bill at the highest level. In the US, you get paid based on how you document. It’s safe to say that EHR software has made it easier to document at a higher level and get paid more.

Notice that the goals of EHR software weren’t to improve health outcomes or patient care. Those goals might have been desired by many, but it wasn’t the bill of goods sold to the practice. Now we’re trying to back all this EHR data into health outcomes and improved patient care. Is it any wonder it’s a challenge for us to accomplish these goals?

When was the last time a doctor chose an EHR based on how it could improve patient care? I think most were fine purchasing an EHR that they believed wouldn’t hurt patient care. Sadly, I can’t remember ever seeing a section of a RFP that talks about an EHRs ability to improve patient care and clinical outcomes.

No, we store data in an EHR so we can improve our billing. We store data in the EHR to avoid liability. We store data in the EHR because we need appropriate documentation of the visit. Can and should that data be used to improve health outcomes and improve the quality of care provided? Yes, and most are heading that way. Although, it’s trailing since customers never demanded it. Plus, customers don’t really see an improvement in their business by focusing on it (we’ll see if that changes in a value based and high deductible plan world).

In my previous post about medical practice innovation, Dr. Nieder commented on the need for doctors to have “margin in their lives” which allows them to explore innovation. Medical billing documentation is one of the things that sucks the margins out of a doctor’s life. We need to simplify the billing requirements. That would provide doctors more margins to innovate and explore ways EHR and other technology can improve patient care and clinical outcomes.

In response to yesterday’s post about Virtual ACO’s, Randall Oates, MD and Founder of SOAPware (and a few other companies), commented “Additional complexity will not solve healthcare crises in spite of intents.” He, like I, fear that all of this value based reimbursement and ACO movement is just adding more billing complexity as opposed to simplifying things so that doctors have more margin in their lives to improve healthcare. More complexity is not the answer. More room to innovate is the answer.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • Over the years, EHR companies were focused on providing efficiencies to support documentation and billing, primarily because this is what the market required of them. Medical groups are always looking for the ability to document more efficiently—with the goal of receiving higher reimbursements—while not negatively impacting patient volume or flow.

    Some groups and EHRs have done a better job than others in capturing relevant data. The old saying of “garbage in – garbage out” applies here. However, the groups that have been able to achieve meaningful EHR adoption, and data capture, are accumulating clinical data that will help pave their way in a value-based world.

    Groups that can leverage a repository of, in essence, unused clinical data, will have an advantage. They will be able to gain the necessary insights to manage the risk associated with their respective patient populations.

    Innovating how we capture, leverage and use clinical data will enable us to effectively transition into a value-based world. Here are some areas that will require focus:

    1. Capture relevant clinical data at point of care
    2. Collection and correlation of outcomes data to measure the effectiveness of each doctor’s approach to delivering care
    3. The use of analytics to gain insights into a medical group’s patient populations with the goal of understanding the risk associated with each population, and the effects different treatment approaches have on outcomes
    4. Leveraging these insights to facilitate a consistent & standardized approach to care that will produce favorable outcomes

    Cultivating innovative approaches to clinical data in ways that provide value to doctors and their patients is the answer.

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