THE METRIC

Hospitals using EMR
2009 – 16%
2013 – 80%

From earliest times, the transition of a physician’s office to an electronic medical record (EMR) / IT system was typically pursued based on expectations of a more advanced, efficient technology and a compelling ROI. One of the important goals was to have patient charts in an electronic format to begin to ePrescribe and for many offices to develop better reporting capabilities.

Disappointment Begins

However, once a system was installed, some of the common problems faced by many offices included:

  • Costly maintenance to update office server-based environments
  • A requirement to use canned reports that did not provide the real-time data envisioned, thereby diminishing their validity and value

Other software design issues arose. For example, I remember in an earlier position, being thrilled to send a text message from a new EMR in a physician’s office only to discover a carrier had to be entered along with the phone number. One step forward, two steps back. Additionally, server-based EMRs located in medical offices required continual support and maintenance by outside IT vendors which came with real financial costs. Unfortunately, too many companies that promised its solutions would “be the best in a paperless world” predictably fell short of the expectations they had created.

A secondary problem arose and continues: end-user competency. Based on observation of actual workflows and processes, the underutilization and incompetency while engaging these systems is profound. Solving this problem can be started by having a second set of eyes review these areas for improvement and optimization. If you think training is expensive, ignorance as a substitute is worse.

However, much benefit can be derived by taking the time to analyze a single area’s workflow associatedwith potential multiple solutions. It is a key to optimizing the processes that are already in place. Significant solutions are not always achieved with the addition of more items from the “wish list”, but rather implementing the proficiencies within the processes and solutions already purchased and installed.

Hope Recedes
And yet, with so much disharmony and so little result, a condition has arisen I call “divorcing the EMR” as organizations and physician groups recognize the need for a more advanced system.

In 2009, only 16 percent of U.S. hospitals were using EMR. Meaningful Use changed the demand and by 2013 nearly 80 percent had begun using EMR programs.

Complexity Advances
Today’s landscape has become even more complex with the implementation of cloud-based versions, advanced analytics, data registries and the emergence of virtual care strategies with the provision of insurance reaching a broader population. These latest changes now stress everything from care delivery, to operational processes, to transparency.

Further, two other factors continue their rapid evolution:

  • MHealth – Smartphones and tablets are part of many patients’ lives. Monitoring outside of the office is a way for patients to stay involved with healthcare accountability.
  • Remote Monitoring Devices – A recent study claimed over two million patients are using home monitoring tools. This is particularly helpful in dealing with chronic diseases such as diabetes or cardiac issues, plus it helps patients be more compliant.

Others have taken note of this stream of challenges. An AMA group in Chicago located at Matter in the Merchandise Mart has been conducting workshops and interactive simulations focused on optimizing healthcare. The group has been using advanced video and audio technologies to better understand new technology products and services, offering a reason to hope again.

We are faced with a different landscape of patients in this innovative world going forward. Patients as consumers may be leading the technology drive while some physicians and healthcare systems are hesitant. Healthcare providers and healthcare organizations need to consider going back and reviewing workflows to help insure their technology is proficient and ready for the next big wave of “innovativestartups”.

Many feel that to control spiraling healthcare costs related to chronic conditions there will need to be a focus on investing in mobile-facing apps, remote health monitoring and virtual care by 2018. Along with the prediction that over 65% of consumer transactions with healthcare organizations will be mobile by 2018, it is important to begin the internal review processes now as the demand for analytics rises to support population health management.

Here are two additional metrics from a Price Waterhouse Coopers Health Research Institute survey of physicians, proving many are in-touch with the times:

  • 1/2 claimed e-visits could replace 10% of in-office patient visits
  • 2/3 agreed they would be willing to prescribe an app to help patients manage a chronic disease such as diabetes

Fair Warning: Adapt or Be Left Behind
It is crucial to develop the highest proficiency with existing technology since the changes ahead will need the sharpest workflows and optimized technologies. There is an opportunity to use these new tools to attract and retain patients. Digital content added to a patient encounter along with healthcare specific social networks are evolving to help healthcare providers deliver services.

Many have learned the hard way: It’s not enough to make the capital investment and initialize the process; optimization is crucial to achieve the full benefit of a system. It will continue to be so in our increasingly data-driven world.