EHRs have long been blamed for fueling clinician frustration and burnout. According to a recent study published in the Journal of Informatics in Health and Biomedicine, 70 percent of clinicians reported experiencing stress related to the use of health information technology. In an effort to address those issues, healthcare organizations have spent countless hours and revenue to rip out inefficient clinical systems and replace them with new technologies—yet clinician satisfaction hasn’t necessarily improved.
Meanwhile, the pandemic is creating disruptive changes across healthcare, forcing leaders to re-assess everything from how care is delivered, to how patients and staff can be kept safe from infection, to how to pay for evolving needs out of already over-stretched budgets. While the situation has created uncertainty, it’s also magnified the need for innovation—including finding less costly and less disruptive alternatives to ripping and replacing existing EHR systems.
For organizations seeking to improve EHR functionality, the focus will continue to be on third-party solutions that enhance usability and are easy to integrate into existing systems. For example, cloud-based services that can be easily added to clinical workflows can extend the value of a legacy EHR by addressing problems such as inefficient workflows, interoperability issues, reporting burdens, and more. If your organization needs an EHR makeover—not a do-over—consider some of the ways that adding solutions from the wider health IT ecosystem can make a big impact.
Workflow improvements. Clinicians often complain of inefficient EHR workflows that diminish productivity and require users to click through too many screens to find the information they need. For example, before ordering lab tests for a patient, a physician may need to search through multiple visit records and reports from other providers to confirm the patient’s history. If the information is not easily accessible, the doctor may give up searching and simply order new tests—which drives up healthcare costs and inefficiencies when duplicate tests take place.
To improve clinical decision-making and help clinicians quickly and efficiently find the specific data they need about a specific patient, organizations can integrate complementary solutions into existing EHR workflows. Such technologies can identify and interpret all the disorganized and complex arrays of medical information from previous encounters, lab reports, inpatient records, and other sources. These tools can then filter clinically relevant, high-value information, and deliver it within the physician’s workflow. Documentation workflows are more efficient, improving clinician productivity, and supporting the delivery of high quality and cost-effective care.
Addressing interoperability gaps. The delivery of optimal care requires that all care team members have access to a patient’s complete medical record. However, the widespread lack of interoperability between disparate systems hinders the efficient exchange of critical patient data throughout the healthcare ecosystem.
Though the recently finalized interoperability rule will eventually improve data-sharing, the pandemic is already pushing back the implementation of widespread changes. In the meantime, care team members are forced to manage immense amounts of data from multiple sources, much of which is redundant and stored in a variety of formats.
Third-party solutions are available to create a normative base and enable the transfer and exchange of data in a faster, more standardized way. For example, a hospital’s EHR could easily integrate a solution that contains mappings to multiple clinical concepts, such as SNOMED-CT, RxNorm, LOINC, ICD-10, and others. By applying these mappings to all the data within the EHR—regardless of the originating provider or clinical system—the information can be standardized. A user can then click on any symptom or diagnosis within a chart note and immediately see all related lab results, medications, co-morbidities, or clinical conditions.
Satisfying quality measures and regulatory compliance. To comply with regulatory requirements and ensure accurate reimbursement, healthcare organizations must track and report on a variety of clinical quality measures (CQMs). CMS, for example, requires providers to measure and report CQMs to confirm the delivery of “effective, safe, efficient, patient-centered, equitable, and timely care.” Quality reporting can be a burdensome process, but providers risk not being accurately reimbursed if they fail to track and report CQMs for the care they deliver.
Organizations can enhance the functionality of their EHRs with the addition of solutions that facilitate the efficient capture of quality measures, as required for reporting and regulatory compliance. Outside applications and services can work behind the scenes to monitor documentation at the point of care and make clinicians aware when specific CQMs are being met; if a CQM has not been met, a clinician can immediately take appropriate action to address care gaps. By verifying clinical documentation in real-time, these solutions can also advise users of potential deficiencies in documentation, as well as identify possible hierarchical condition category codes (HCCs). Such tools enable more complete and correct documentation, facilitate accurate coding and reimbursement, and ease many of the inefficiencies associated with quality reporting.
As healthcare organizations address new competing priorities, now is not the time to replace legacy clinical platforms with entirely new solutions. Instead, providers can look at giving their existing systems a makeover with third-party services and solutions that seamlessly integrate with EHRs to improve functionality and extend usability.
David Lareau is CEO of Medicomp Systems, which provides physician-driven, point-of-care solutions that fix EHRs.
