Since the passing of the Affordable Care Act in 2010, electronic health records (EHR) systems have proliferated among the nation’s healthcare providers, from hospital-owned solutions to freestanding outpatient service providers.
The Healthcare Information and Management Systems Society released its 2016 study of EHR adoption earlier this year, noting that 78% of respondents representing a freestanding outpatient facility had adopted some type of EHR solution, an increase of 30% over the last five years. For hospital-owned outpatient facilities, 92% have what they call “live and operational” EHR systems, meaning adoption is now almost universal.
For the remaining medical practices that have avoided adoption of an EHR system, implementing one may seem like a daunting task, but it doesn’t have to be. Doing so will allow those doctors to bring their practice into a new era of healthcare, increasing efficiency and their ability to serve patients.
First Step: Assessment
When implementing an EHR system, the first things a medical practitioner must do is assess their current practice to understand why they need to implement EHRs and envision what the future will look like. This ensures that they aren’t just simply adopting an EHR solutions to comply with modern standards, but possess a clear understanding of the reasons why an electronic records system is necessary and how it will benefit them. By the end of the process, healthcare providers will likely be excited to begin the process of implementation.
To get started, practitioners looking to adopt EHRs should answer a few questions:
- Can administrative processes be better organized and documented?
- Is the staff computer literate?
- What does the clinical workflow look like? Is it understood by the staff and efficient?
- Can data collection processes improve?
- What specific needs does the practice need to address? Are they specialty specific?
- Is the financial capital necessary for these upgrades readily available?
In envisioning the future, practitioners need to simply consider what will be different for their patients, staff and providers. Goals for EHR implementation can be tied to revenue, the work environment or clinical needs.
Setting these goals can guide implementation of EHR systems and should help polish the processes beyond the initial system implementation. Following the assessment process, practitioners should have a designated team to lead them toward EHR implementation, a universally adopted vision and measurable, attainable goals.
Next, practitioners will have to conduct what is sometimes referred to as a “start, stop, continue” assessment, in which they identify tasks or processes that they will continue doing, stop doing or start doing.
After the assessment is complete, the next step is to examine current workflows and plan out how implementation will create new patterns that increase efficiency and eliminate duplicative work.
Also part of this process is the creation of a contingency plan in the case of system failure, as well a transition plan for the move from paper to electronic records, including charts or any data elements that have to be scanned or transferred from a previous solution to a new EHR system, such as patient demographics.
Lastly, taking precautions to ensure the security of an EHR system is vital to its success. The potential for fraud involving EHRs is a growing concern, so taking care of security concerns is no small matter.
After the planning phase, practitioners will want to select an EHR system that suits their health informatics strategy and begin implementation while training employees to use it. This is sometimes called “meaningful use,” defined as the use of certified EHR technology in order to achieve health and efficiency goals around patient care.
There are two stages of meaningful use for practitioners to achieve, which set the bar for the quality of data capture and information sharing. These stages include five patient-oriented objectives such as:
- Improve quality, safety and efficiency
- Patient engagement
- Public and population health improvement
- Privacy and security of personal health information
- Improved care coordination
It’s not uncommon for practitioners to encounter challenges as they roll out EHR implementation and join the health information exchange (HIE). An emerging solutions market has stepped in to provide practices going through the process of adopting EHR assistance in the form of software for streamlining the use of both EMRs and EHRs.
Software solutions, be it something as large as EPIC or Allscripts or something more niche, are proving to be an important part of providing a better user experience for healthcare providers, practitioners and patients. Through software that can be used in a wide variety of settings, from hospital to patients’ homes and mobile devices, practitioners are getting increasingly accurate data that allows them to care for their patients better and improve internal process to decrease the amount of work done by staff.
A 2013 report from the U.S. National Library of Medicine, the biggest obstacle to universal EHR implementation was not technology, but a resistance to change. Three years later, the overwhelming inevitability of EHRs seems to have prevailed. Today, it’s up to practitioners still holding out to adopt these practices or alienating themselves from the rest of the healthcare marketplace.