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Planning is Key to Maximizing Next Wave of EHR Tools


For the small- to mid-size medical practice, and even for some small hospital, the challenge of keeping up with technology changes can be daunting.

Doctor with tablet

While healthcare providers large and small continue to make expanded use of Electronic Health Record (EHR) tools, the vast majority—96%—believes that their technology infrastructure is ill prepared for the next iteration of EHR functionality.

That’s the result of a new report from MeriTalk, and sponsored by EMC2, a computer data storage company.

And it doesn’t surprise Sean Morris, director of sales for Digitech Systems, Inc.

“They’re still struggling to get their arms around what they have,” Morris explains. “And more important, bridging the gap between paper-based files with historical information and the latest wave of technology that houses a lot of the electronic data they’ve recently captured.”

Trying to Keep Up

For the small- to mid-size medical practice, and even for some small hospitals, the challenge of keeping up with technology changes can be daunting. Between meaningful use and the new wave of EHR tools, physicians are asking, how do I afford this in my practice, and will I need costly upgrades to my infrastructure every few years?

Morris says those questions are spot on.

“Let’s face it, EMR technology has not really been an affordable solution, both from a software standpoint, and from an infrastructure standpoint for smaller practices that take advantage of it,” he says. “Yet, they’re required to, right? So, I think there’s a huge fear as we continue to see technology evolve that, hey, I’m going to have to change out my hardware or my infrastructure in order to support this next wave or this new evolution of technology.”

Robert Hitchcock, MD, FACEP, chief medical informatics officer with T-System Inc., and a practicing emergency physician, agrees. He says the challenge of keeping up with meaningful use has been too much for many small medical practices.

“We’re seeing a lot of physicians opting out of stage 2 and taking the CMS hit,” Hitchcock explains. “And the main reasons for that are they’re going through pretty constant changes, and these changes are very disruptive to the practice and their operations.”

Cost-benefit Analysis

Walking away from the next wave of EHR tools, however, also means leaving a lot of data on the table. And in a healthcare environment giving more weight to value-based outcomes and linking that to reimbursement, an alternate strategy might be appropriate.

Stepping back and conducting a cost-benefit analysis, Hitchcock says, can be beneficial on many fronts. He believes that medical practices and hospitals need to get back to some basics. They need to look at how they can run their operation effectively and efficiently. And not just with regard to how they meet the regulatory demands of the clinical quality data reporting, but how they can reduce their costs internally.

“Resources are scarce,” says Hitchcock, noting that medical practices need to focus on reducing resource costs, and hardware costs, and driving true efficiency across their organization.

“A cost-benefit analysis then will focus on not only their cost inputs to the organization, but also on the back end,” he says. “How can I more effectively get patients through the system and reduce length of stays, which is a direct impact to their expenditures. And, how do they make their internal physicians more productive, which will help drive volume as well.”

Have a Plan

Morris says it’s important for medical practices to formulate a plan; to have a strategy for protecting information as well as providing access to information, which he believes is the source of efficiency gains.

“As the population now starts to embrace all of the options that are available for healthcare insurance, you’re going to see a ton more people coming into the office to be seen by the doctor,” Morris says. “You have to have a plan around protecting that private health information. Have a plan around how you’re going to provide access, so the physician assistant, the doctor, or even the patient, through a patient portal, has access to their information.”

Once physicians understand their needs, and the type of data they want to collect, as well as the options for selecting and securing that data, then they can begin evaluating the available technology, as well as a vendor that can help them pull all the pieces together.

And, particularly with small medical practices, don’t overlook staff training and buy-in.

“It might be great that you have this new technology with all these capabilities,” Morris says. “But if you don’t have, as part of your plan, a way to get buy-in from the interoffice personnel who are going to be using this new technology, and a way to train them, then it’s probably as good as shelf ware.”

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