So, we slammed in the EMRs to get the meaningful use money. Many organizations did not have an effective plan for how to implement the EMR in order to improve quality of care of care delivery and efficiency. They were only focused on getting the EMR implemented so that quality and outcomes data could be captured and submitted to achieve expected EMR reimbursements.
To add more pain to this equation, organizations in many cases implemented EMRs in ambulatory environments that were not easily integrated with the acute care EMR. They got their Meaningful Use Stage 1 and 2 reimbursements, but at the expense of burdening physicians and clinicians with obtuse and complex workflows that now are driving some physicians to early retirement. This is not a situation that provider organizations can endure for long.
Now, the buzzword of choice is ‘EMR Optimization.’ For now, let’s call it EMR improvement. It’s driving organizations to seek out expensive consulting firms for engagements to improve EMR utilization and quality of care. To me, this is a step in the right direction — if a little aggressive, not to mention expensive.
I’d suggest that provider organizations already have the resources they need to successfully develop EMR optimization strategies and the execution tactics for EMR upgrades, modifications, or perhaps even EMR replacements.
The key is clinicians. The majority of clinicians are not happy with their EMRs. But they do understand the importance of the EMR for improving care quality, care delivery efficiency, and patient safety. They also understand the economics of the EMR environments, and they do not want to put their organizations in financial jeopardy. They are interested in providing input on how the EMR environment can be improved, which provides the catalyst for the organizations to begin working on EMR improvement strategies.
An important consideration, when creating new EMR improvement strategies, is identifying and paying physicians who are more experienced and knowledgeable of the EMR environment to act as conduits between the physicians and executive leadership for EMR operations. In some organizations, the CMIO (or in larger systems, several CMIOs) fill this role.
In other organizations, these are physicians that continue to provide patient care but have part of their time reimbursed for assisting with physician interactions and training to drive EMR improvements. No matter the approach, the key is to find and engage the physicians who can sustain physician interactions for the continuous improvement of the EMR environment in the organization.
- Continuous improvement? Yes, provider leadership and executives need to further understand the EMR is an environment that is dynamic and must constantly transform to adjust to the needs for addressing all the financial and clinical needs of care delivery.
- Financial needs? Yes, the EMR is going to be the foundation for gathering data needed for value-based care, which includes capturing the analytics necessary for managing and monitoring the most efficient and cost effective care delivery processes.
- Governance, governance, governance. Provider organizations that have success with improving the EMR experience for their physicians are establishing strong governance environments for the EMR that is run by the physicians. The care and feeding of a strong EMR governance group will pay dividends for EMR return on investment down the road.
One final tip: It is important to design and implement the EMR so it supports patient care in the most efficient manner possible, while capturing financial data as a byproduct of the process. This is so that physicians are not burdened with extracurricular documentation requirements that do not improve efficiency or care quality. Difficult? Yes, but this industry has the intellectual capital at the provider and EMR vendor levels to make this happen. Organizations need to develop and begin to implement their EMR improvement strategies among their physicians now.