Quickly evaluate an EHR

Quickly and easily evaluate an EHR, any Electronic Health Record, by asking how it supports you with the following functionality. Quickly get focused on what matters and use the expertise of others to assess the system.

Interoperability:  

Does it share well with others?  In today’s practice environment, no man (or woman) is an island.  They can’t be for the sake of their own practice, and for the care of their patients.  Data, which is information for billing and clinical care must be able to flow back and forth between an increasing number of parties.  

Can the EHR share with such diverse systems as Health Information Exchanges (HIE), pharmacies, payers, radiology/imaging services, referring physician, cancer and immunization registries, as well as other disease state registries, hospital networks, as well as the electronic devices increasingly being added to an office?

Today’s EHR must be interoperable, able to share two ways with others. The world of healthcare treatment and reimbursement is increasingly interdependent, and if you are not part of this sharing world with data, you will not only lose out on patient information that could impact the care you render, but also be excluded from even participating in some of the new, and increasingly complex reimbursed offerings.

Ease of use: 

Technology can be hard.  How easy is it to actually use? Does the Electronic Health Record allow for customization of your template for documenting a patient visit, or do you have to twist yourself into a pretzel to document? How flexible is it to follow your usual patient flow, enabling you to truly personalize your operations?

Optimization of your workflow:  

While mirroring your patient flow may be necessary for comfort in transitioning to a system, dashboards that let you monitor your operation and reporting capabilities are necessary to allow you improve your practice. Doing is the status quo, improving is the way to make your practice a success. If an EHR does not contribute to practice improvement across its entire operation, from productivity to revenue to improving the quality of the services you provide, the EHR is not contributing to making yours a better practice.

Patient engagement: 

How does the Electronic Health Record enable you to engage patients? Yes, a patient portal, but what does it allow you to do with your patients that increases satisfaction, service quality and reduce your operating costs?  

Needed is the ability of your patients to securely request appointments and refills online, receive test results as they become available, utilize educational material and update their health status, history, demographics, and insurance information while subscribing to valuable electronic tools and services.

KLAS Rating: 

KLAS Research is an accurate, honest and impartial research on the software and services used by providers and payers worldwide. 

Their extensive research and evaluation process provides an objective review of EHRs and related software. 

You need to ask; “How does KLAS rank you?” to every EHR you might be considering.  The extensiveness of KLAS ranking which takes into consideration actual user experiences is in-depth due diligence. 

Choose the EHR that is right for you, but make sure it is highly ranked by KLAS at a minimum.

A Real Case for the Return on Investment of EHR Implementation

If there is one thing that there is no shortage of during the EHR implementation transition, it is cynicism. Much of this negativity is certainly warranted when providers are running into legitimate budgetary and staffing problems, but an even larger portion of the medical community seems to view speaking skeptically as a personal hobby. Perhaps this devout skepticism comes from a fear of change, but even more likely is that they think that the evidence for EHR ROI (return on investment) simply is not there.

Well, we have news for them: EHR ROI is real, and it is not isolated to just a few anomalies. There have been multiple studies confirming that some provider organizations benefited greatly from EHR implementation.

While we must acknowledge the real struggles providers are facing, we must also recognize collectively as a community that negative EHR implementation outcomes are not inevitable. To stir in this dose of much-needed positivity, here are a few examples of providers that genuinely saw EHR ROI within a reasonable time frame:

Reliant Medical Group

Hailing from Worcester, Mass. but with facilities throughout Central Mass., Reliant Medical Group was an early adopter of EHR Software Systems. After shelling out an astounding $24 million in overall costs, the organization says that it is already seeing tangible financial and administrative benefits.

Foremost, the more precise coding and documentation capabilities of EHR are credited with increasing their Medicare Advantage reimbursements by $2 million annually. They also saw a huge surge in their compliance rate for Medicare Advantage patients who had chronic kidney disease diagnoses. Within a three-year period, compliance for these patients increased from 20 percent to a whopping 80 percent.

Additionally, the time and cost of transcribing dictation has fallen significantly for Reliant’s centers — a full 63 percent, to be exact.

Reliant’s Larry Garber even touted that EHRs successfully made good on their promise to reduce medical mistakes. Looking specifically at his radiology departments, there was a consistent problem with the wrong tests being ordered. After customizing a one-click feature that would reveal the specifics of every test ordered, radiologists could vet the pending test requests and confirm or correct them before they were scheduled.

In total, the percentage of radiology tests requiring expensive ordering changes post-scheduling declined from 12 percent to four percent. This reduction saved both patients and providers resources, especially the radiologists who had more time to perform tests that were genuinely needed.

Small Practice EHR Wins

While not every provider has the budget to lay down a cool $24 mil on the table for EHR, many smaller pilot clinics were still able to budget for their EHR implementation properly and see some EHR ROI within a few years.

Here are some five-year case studies courtesy of Providers Edge:

●       OB/GYN of West Michigan saw a 65 percent return on investment after cutting six full-time-equivalent staff positions in transcription and nursing as a result of increased efficiency.

●       Nash OB-GYN Associates, hailing from Rocky Mount, North Carolina, saw a huge 71 percent reduction in both transcription and supplies costs.

●       Lakewood Family Medicine of Holland, Michigan enjoyed a 50 percent EHR ROI, with savings of $100,000 per year on reduced transcription costs alone. Administrator Beth Zandra even fully-endorsed the decision, saying that, “There’s no way my physicians would go back to paper medical records.”

●       One Dr. Jack Dekkinga had an unusually-glowing case for EHR ROI. While his costs for transcriptions and supplies fell just like the other study participants, his receipts also grew by 32 percent coupled with an 18 percent increase in total patient encounters. His small practice was able to achieve an astounding 240 percent ROI, allowing him to pay for the costs of his EHR system in just over five months.

Getting Realistic About EHR ROI

Not every provider organization will see the storybook gains described above, but they will also likely not endure the catastrophic losses bandied about by devout naysayers. The real point is to illustrate that losses are not inevitable.

In fact, one of the most comprehensive studies on the subject of EHR implementation found that small practices would recoup their losses after two and a half years, on average. After that, they could expect incremental gains in the years to come. While this timeline may seem drawn out for some, providers must come to grips that the expectations of EHR implementation are coupled to the promise of better efficiency and better patient care. Tangible, cash results thus may pale in comparison to the revitalized landscape that EHR promises in the long run.

If such idealism is not enough to float your boat, at least take comfort in the fact that significant Medicaid incentives can be had if you implement EHR sometime next year. Between incentive programs like these and the potential gains evangelized by those above, now is the time to create a serious EHR implementation strategy and adjust to what will inevitably color the future of modern medicine.

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