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EHR Implementation Accomplished – What’s Next?

Posted on April 12, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When you look at the world of hospital and health system EHR implementations, it’s fair to say that we can say Mission Accomplished. Depending on which numbers you use, they are all in the range of about 90% EHR adoption in hospitals. That’s a big shift from even 5-10 years ago when it comes to EHR adoption in hospitals. It’s amazing how quickly it shifted.

While it’s easy to sit back and think “Mission Accomplished” the reality is that we still have a LONG way to go when it comes to how we use the EHR. Yes, it’s “Mission Accomplished” as far as getting EHRs implemented. However, it’s just the start of the mission to make EHRs useful. I’d suggest that this is the task that will take up CIOs time the most over the next 5 years.

I think that most people looking at their EHR think about next steps in two large baskets:EHR Optimization and Extracting Value from EHR Data.

EHR Optimization
Most EHR software was slammed in so quickly that it left the users’ heads spinning. Hospitals were chasing the government money and so there was no time to think how the EHR was implemented and the best way to implement the EHR. We’re paying the price for these rushed EHR implementations now.

What’s most shocking to me is how many little things can be done for EHR end users to make their lives better. Many EHR users are suffering from poor training, lack of training, or at least an ignorance to what’s possible with the EHR. I’ve seen this first hand in the EHR implementations I’ve done. I know very clearly that a feature of the EHR was introduced and the users were shown how to do it and 6 months later when you show that feature to them they ask “Why didn’t you teach us this earlier?” Although, they then usually sheepishly say, “Did you teach us this before? I don’t remember it.” At this point it’s not about who we blame, but is about ensuring that every user is trained to the highest degree possible.

The other EHR optimization that many need is an evaluation of their EHR workflow. In most EHR implementations the organization replicates the paper processes. This is often not ideal. Now that the EHR is implemented, it’s a great time to think about why a process was done a certain way and see if there is a different workflow that makes more sense in the digital world. It’s amazing the efficiency you will find.

Extracting Value from EHR Data
As I just suggested, most EHR implementations end up being paper processes replicated electronically. This is not a bad thing, but it can often miss out on the potential value an EHR can provide. This is particularly true when it comes to how you use your EHR data. Most hospitals are still using EHR data the way they did in the paper world. We need to change our thinking if we want to extract the value from the EHR data.

I’ve always looked at EHR data like it was discovering a new world. Reports and analysis that were not even possible in the paper world now become so basic and obvious. The challenge often isn’t the reporting, but the realization that these new opportunities exist. In many cases, we haven’t thought this way and a change in thinking is always a challenge.

When thinking about extracting value from the EHR data, I like to think about it from two perspectives. First, can you provide information at the point of care that will make the patient care experience better for the provider and the patient? Second, can you use the EHR data to better understand an address the issues of a patient population? I’m sure there are other frames of reference as well, but these are two great places to start.

EHR Optimization and creating value from EHR data is going to be a great thing for everyone involved in healthcare and we’re just at the beginning of this process. I think it’s a huge part of what’s next for EHR. What’s your take? What are your plans for your EHR?

Meaningful Use Drove the Data Gathering

Posted on February 5, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently heard an interesting comment that “meaningful use drove the data gathering.” As you look at meaningful use, it has been the driver of data gathering in healthcare. I’m not sure any other technology has gathered more healthcare data than EHR software (I guess the health plans might have a case here, but it’s different healthcare data). Much of the EHR adoption is attributed to meaningful use.

While it’s great that we’re gathering all of this healthcare data, it’s worth asking the question of what’s being done with this data. Are we meaningfully using the data we’ve gathered? Is the data in a format that we can use the data?

The past 3-5 years of EHR has been defined by EHR systems that converted the paper chart world into an electronic chart world. I believe this is a great step forward, but it’s only a step. The next 5 years we’re going to start using the data that’s been gathered into EHR software and that will change healthcare.

One challenge we face is that many EHR vendors are locking in the data. They’ve gathered the data, but they haven’t set it free so it can be used for good. I believe locking in the data is bad for healthcare, but I also believe that it’s a bad business decision by EHR vendors.

In the future, EHR vendors will be differentiated more on the marketplace of third party applications they support than on their own in house developed apps.

I think we can barely imagine what benefits will come from the proper use of the data we’ve collected in EHR software. EHR data is a treasure trove of opportunity. We just need EHR vendors to start acting like the database of healthcare and stop trying to be the end all be all solution. Then, we’ll see innovation that we haven’t even imagined come into view.

To Purge or Not To Purge EHR Data

Posted on January 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In every healthcare organization I’ve seen there’s been a real push and pull when it comes to EHR data retention. In fact, this doesn’t just happen in healthcare, but in a lot of organizations outside of healthcare as well (usually around email). The question is how long should we hold on to the data. In healthcare, many states have laws about record retention and so that often lays the groundwork for the discussion. However, once it gets past what the laws required there’s usually a good debate between the two extremes of keeping the data forever and purging the data as soon as is legally allowable.

If you ask the risk management professionals at a hospital, they’ll likely want the data purged as soon as is legally possible. They see the old EHR data as a liability and a risk for the hospital. If the data’s gone, then the liability is gone (or at least harder to prove). Certainly the data could set you free in some cases, but I think it’s safe to say that old data is more likely to hurt you than help you in a legal situation.

On the other side of the fence are the researchers (which in many cases are the doctors at the hospitals). As a researcher you want to have as much data as possible. It’s almost like committing a crime to purge any data that could be used to support your research efforts today or in the future. They would love to keep any and all EHR data forever.

I’ll be interested to see how this debate evolves going forward. Will the “Watson” empowered EHR software need to have all the data from the beginning to really be able to understand a patient and provide appropriate treatment recommendations? Will EHR vendors finally get on board and provide the capability of purging old EHR data? As it stands today, they really don’t offer this feature. It’s almost sacro saint to delete anything from an EHR. Nothing is ever deleted from an EHR, but is only hidden or made inactive. Otherwise, you lose the credibility of the record if something can be deleted.

This battle will likely never end. We’ll always have people wanting to purge the records to avoid liability and those who want to keep the records forever. Although, I think over time we’re more likely to move to a world where no data is ever purged. At best it will be moved off to a vendor neutral EHR archive and they’ll address the liability issues through other laws.