When EHR Enablement is Like a Fragile House of Cards

I was a kid who loved creating a house of cards. The structures relied on both balance and friction in order to stay upright. Card houses built on a shaky foundation collapsed quickly. The fun, for me, was seeing how tall I could build these structures without collapse. I built my houses with strong foundations to ensure height and weight were equally supported. This took time and patience, but it became a challenge for me. In the end, the houses I “fortified” generally stood the tallest. I equate this love of card houses with my ability to support EHR clients. From 2002-2012, I followed physicians and clinicians into exam rooms, became a scribe, stayed late, wrote templates, and added necessary shortcuts to improve role-based usability. The extra time and patience paid off because by doing these things I helped physicians build a strong foundation for future success. Many times, I brought along an independent IT vendor to connect computers, card scanners, fax machines, and ancillary hardware. You see, EHR enablement was just not enough. The capital purchase and subsequent implementation were not sufficient drivers for future success, and the name of the system vendor didn’t matter. All were equal opportunity disasters without sufficient customization or additional services so physicians and staff could use the system efficiently.

Fast forward to 2020. According to Definitive Healthcare, more than 98 percent of hospitals in the U.S. use an EHR system. Adoption has increased exponentially, yet usability has continued to decline. According to an article in the National Institute of Health, “despite massive effort and investment in health information systems and technology, and many years of widespread availability, the full promised benefits of EHRs are far from fruition. The reality is that most physicians still have to fax and mail patient records the way they did a decade ago.”

Why haven’t we created a foundation for success with EHR/EMR systems? For starters, proprietary databases and the lack of standardization across the industry creates complications. In addition, value-based care and the onslaught of rules and regulations have made it difficult for smaller vendors to keep up. Many hospitals and provider organizations who had just learned to use their previous EMR find they need to upgrade to keep up with the requirements of population health, mergers, acquisitions, or data analytics. The changes make it difficult to achieve a level of comfortability with EHR systems. The constant need to update and upgrade make the earlier foundation crumble under the added disruption of change.

EHR vendors and disparate applications don’t make it any easier. For most providers it feels like documentation, not patient care, comes first. The copious amounts of data required just seem to grow every year, as if feeding a beast, requiring unrealistic amounts of time and input without realistic support to easily get the data into the systems, or share it across locations of care. As a result, a large portion of the physicians’ time has been redirected to data entry. Providing quality care has become more difficult due to increased patient loads and administrative challenges. Physicians use scribes to offload the “point and click” of increased demands for documentation, though this is not without risk. There are HIPAA issues, privacy concerns, patient safety issues if the scribe is not familiar with medicine, and coding concerns.

In theory, the EHR should improve communication among health care professionals, make it easier to access and review patient data, and cut through the billing bureaucracy. Yet, according to the AAFP, burnout prevalence remains considerably higher among physicians who use EHRs. Necessary information is often buried or presented in a way that doesn’t clearly highlight all potential patient health issues, making it difficult to have direct conversations and holistically care for the patient. In a rush to check boxes, satisfy alerts and move to the next screen, both providers and patients end up suffering.When this occurs, the fragility of the foundation collapses and the whole house comes tumbling down.

At Boston Software Systems we created a campaign called #bridgethegaps on Twitter. This began as a way to share what we do, how we do it, and why it matters. It’s received a great response, largely because people didn’t know Boston Software Systems, but also because of the need to resolve tedious tasking in the EHR. Whether it’s data migration efforts, merging information between disparate systems, revenue cycle management tasks, or just creating a better process, hospitals and health systems easily relate to the gaps that currently impede progress. Because, and this is really difficult to say, as we enter 2020, EHR enablement is STILL just not enough. To build a strong foundation we have to increase productivity while decreasing the administrative data burden that is associated with the EHR. No one vendor can do this alone.

A strong foundation eliminates extra steps, increases efficiencies, and helps clients overcome the gaps that vendors and applications often leave behind. Once this foundational “armour” is in place, we can begin the task of aligning systems and services to the people who use them.

Why Boston Software Systems?
A reputable healthcare automation partner can help you identify processes that will benefit most from increased automation and allow you to scale with ease. Finding a partner with an exclusive healthcare focus ensures the solution will be aligned with workflows, reduce pain-points associated with process implementation, and speed alignment to future health goals.

Boston Software Systems’ experience has been ensuring automation projects remain on track since 1985. Working across a wide-range of vendors and applications, we are experts on streamlining workflows, reducing costs, and improving usability for hospitals, health systems, provider organizations, and technology partners. We have worked with all of the leading EHR vendors, optimizing usability and role-based user satisfaction.

Give us one hour, we will tell you what can be up in running in days or weeks. With over 95% of our healthcare automation projects being completed in under 30 days, savings are right around the corner.

Be sure to follow our hashtag #bridgethegaps on Twitter to join the conversation!

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