The decision-makers in hospital C-suites have healthcare information technology on their minds these days, but what they are thinking is not all warm and fuzzy. In fact, I detect a certain amount of dread about how it will fit into the future. Even with generous federal incentives for meaningful use of HIT, many hospitals still have not committed to an electronic medical record. Just this past September, HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society, estimated that only 41 percent of hospitals were ready to meet Stage 1 of meaningful use.
Of course, the high price of implementing EHR has put off a lot of executives, but I believe their concerns run deeper than that. In a Dell Computer survey of hospital executives last March, only 47 percent thought EHRs would be a positive step, and almost 80 percent were anxious about the need to train physicians and staff to use the new technology.
That is not exactly a stunning endorsement of EHR. Hospital executives seem to regard EHR implementation as a long and difficult slog, with uncertain results at the end. We have all heard the horror stories when EHRs' promised magic somehow went horribly wrong. Sometimes physicians and clinical staff had major problems navigating the system and had to stay late to fulfill their new data-entry responsibilities. Clinical care was disrupted, physicians were up in arms and the hospital did not expect a return on its investment for many years to come.
It's time to step up to the plate
All of these problems can happen, but I strongly believe we need to move ahead with EHRs and other technology. Potential problems should not take us off our goal. Rather, they should be instructive examples of how we need to handle EHR implementation better than others did in the past. The advantages of EHR are obvious by now. It can reduce medical errors, improve patient services, increase efficiency, improve workflow and reduce readmissions. A recent study of Philadelphia hospitals, for example, showed that it even reduced readmissions by an average of 7 percent.
Those who ignore EHR will miss the train as it is about to leave the station. The evolution toward advanced healthcare informatics may have been slow in the past, but it is speeding up. The HIMSS Analytics survey I mentioned before found that while still only a minority of hospitals are ready for Stage 1 of meaningful use, that number rose 16 percent from February to September 2011. Healthcare IT is coming sooner than many in this industry care to think!
Put yourself at a competitive advantage
Hospitals and physicians are going to need to adopt EHR and use it, or else they will lose patients to other systems who successfully make the transition. There are all kinds of ways that healthcare IT can help make your hospital more competitive. For example, having a good EHR system in place can help make you eligible for new programs, such as pay-for-performance and accountable care organizations.
Healthcare IT can also help with recruitment of physicians. In a recent survey by Epocrates, maker of point-of-care medical software, 70 percent of current medical students said EHR technology would be an important factor in deciding where they would practice medicine. And last but not least, you can lure more patients to your hospital with a robust healthcare IT system with features such as patient portals. The Dell survey found that 83 percent of hospitals are favorably interested in patient portals and other ways to do business online. While only 18 percent had partially or fully implemented a patient portal, another 62 percent were planning to do so.
Some steps to keep you safe
If you are still deciding whether or not to implement EHR in the near future, there are ways to keep your institution safe from the perils of healthcare IT. Here, culled from the experiences of other hospital executives, are some steps to take.
Take time to do the groundwork. Most major health systems underestimate the amount of time it takes to implement EHR. You need time to get input from physicians and staff, choose a vendor, plan implementation, train staff and test software extensively before you go live.Involve physicians and other clinical staff. These key groups should be involved from the beginning, when you are just starting to plan. The EHR system you choose has to fit their needs and be easy for them to use. If they are not on board, your system is likely to fail.Find the right vendor. The vendor you choose should be responsive, and the system should be flexible enough to allow for improvements and modifications that your primary users identify. Your groundwork should involve performing a workflow analysis.Hire experienced IT personnel. Seasoned IT personnel can make a huge difference in a successful implementation, but as more hospitals implement EHR systems, the growing demand for them makes it harder to find the right personnel. You may have to pay more to find the right people.Don't skimp on training. Recognize that people who will be using the system have very different digital abilities and learning styles. Give them as many ways as possible to learn the ropes, including standard classroom training, one-on-one sessions, manuals and online exercises. This rich menu may cost extra, but it’s worth it.Plan for post-implementation snafus. No matter how well you plan, understand that there will be problems. After your go-live date, meet with physicians and staff to evaluate problems and deal with them head-on.
The transition to healthcare IT may seem daunting, but don't be discouraged! EHR is not something you can put off if your want to be a viable player in 2012 and beyond. It's time to move ahead and be part of the future