The following is a guest blog post by Justin Campbell Vice President, Strategy, at Galen Healthcare Solutions. Learn more about their work by downloading their EHR Clinical Optimization Whitepaper.
Resistance to change is natural. People are uncomfortable with it. Organizations are frightened by it. Acceptance of healthcare information technology took a long time and even in these first two decades of a new century, despite incentives such as the Meaningful Use program, and promises of increased efficiency, implementation of Electronic Medical Records has been a bumpy ride.
Between 2008 and 2016, healthcare organizations spent more than 20 billion dollars adopting electronic health record systems. Many different approaches were applied. Many HCOs decided to act quickly, using what we now call a “Big Bang” fix. Installations of generic systems were in place but users of the new systems were unhappy. In 2013, with the process well underway throughout the nation, two thirds of doctors polled said they used EMR systems unwillingly, with 87% of these aggravated physicians complaining about usability and 92% of physician practices complaining that their EMRs were “clunky” and/or too difficult. Specifically, only 35% reported that it had become easier to respond to patient issues, one third said they could not more effectively manage patient treatment plans, and despite the belief that technology would permit caregivers to spend more time with their patients, only 10% said this was occurring.
The medical side was not alone in expressing dissatisfaction. Hospital executive and IT employees who had replaced their Electronic Health Record systems reported higher than expected costs, layoffs, declining revenues, disenfranchised clinicians and serious misgivings about the benefits gained:
- 14% of all hospitals that replaced their original EMR since 2011 were losing inpatient revenue at a pace that would not support the total cost of their replacement EMR
- 87% of hospitals facing financial challenges now regret the decision to change systems
- 63% of executive-level respondents admitted they feared losing their jobs as a result of the EMR replacement process
- 66% of the system users believe that interoperability and patient data exchange functionality have declined.
Not all reviews are negative. There is strong support and appreciation for EMRs in some Healthcare Delivery Organizations (HDOs) who believe well-designed EMRs save time and support clinical workflows. But, there is no escaping the majority sentiment: EMRs are not designed for the way providers think and work.
Today, most HDOs are at a crossroads. They can start over with a new EMR or optimize the one they have. The case for a do-over is supported by sub-standard vendor support for their existing systems and the increase in mergers and acquisitions, which drive system consolidation. One fifth of large practices and clinics report they intend to replace their EMRs and studies show that the EMR replacement markets will likely grow at an annual rate of 7%-8% over the next five years. The case for the status quo is made primarily by the HCOs that do not have the financial resources to undertake EMR replacement.
All options face the same key inter-related questions: how to generate additional margin? How to maximize return on technology investments? Which path will best serve the HCO, caregivers and patients?
This is a bit of vicious circle. HCOs are cash-strapped and the transition from fee for service to value-based care exerts downward cost pressures, exacerbating the problem. But patchwork fixes have not resolved that problem. Alternatively, some attempted to do too much too quickly and became frustrated because they lacked the depth of experience and knowledge to perform remediation. And, as KPMG concluded after studying the problem, “The length of time to resolve the issues increased and frustrations mounted as clinical, senior management, IT and human resources staff found themselves spinning their wheels.”
Like a patient being pressured to swallow medicine, HDOs are beginning to accept their situation. According to a recent survey conducted by KPMG in collaboration with CHIME, 38% of 112 respondents ranked EMR/EMR optimization as their top choice for the majority of their capital investments for the next three years.
EMR adoption is already approaching maximum levels. Consequently, healthcare delivery organizations have begun to shift their EMR strategies from short-term clinical documentation data repositories to long-term assets with substantial functionality in support of clinical decisions, health maintenance planning and quality reporting. They are coming to see their IT investments as platforms rather than limited systems of record or glorified data banks. In short, they now understand that the capture of information is only the most basic attribute of an EMR, and that instead, the EMR in which they invest can be flexible and extensible, capable of adopting emerging technologies that are driving insights to the point of care.
Assess opportunity, formulate strategy, improve usability & derive additional ROI & by downloading our EHR Clinical Optimization Whitepaper.
About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell and LinkedIn.
About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.