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EHR Value Realization – Rx for Success

June 30, 2017
by Tonya Edwards, M.D., Impact Advisors
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CIOs from 13 prominent healthcare organizations convened in April 2017 for the annual Scottsdale Institute Spring Conference CIO Summit
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Executive Summary: CIOs from 13 prominent healthcare organizations convened in April 2017 for the annual Scottsdale Institute Spring Conference CIO Summit. This session, a follow up to the full conference session, “Prove that EHRs Add Value,” examined how EHRs (electronic health records) are providing value to healthcare organizations, some of the primary challenges and barriers for realizing value, and the key organization relationships to ensure success.

CIO Summit Participants: George Conklin, CHRISTUS Health; Robert Eardley, Houston Methodist; Mark Lantzy, IU Health; Ken Lawonn, Sharp HealthCare; Mark McMath, Methodist Le Bonheur Healthcare; Patrick O’Hare,  Spectrum Health; Cecilia Page, UK HealthCare; Rich Pollack, VCU Health; Chuck Scully, HonorHealth; Bruce Smith, Advocate Health Care; Tim Thompson, BayCare Health System; Joel Vengco, Baystate Health; Jim Veline, Avera

Organizer: Scottsdale Institute; Sponsor: Impact Advisors; Moderator: C-Suite Resources (Ralph Wakerly)

Introduction

The healthcare industry has spent billions of dollars on electronic health record systems across the past few years, but not all organizations are seeing meaningful returns on their investments.

A 2012 study by the National Board of Economic Research (NBER) revealed that hospitals that invested in advanced EHRs and did not have the expertise to innovate to improve operations wound up increasing their overall costs by 6 percent, even after several years. In contrast however, some leading hospitals were able to realize substantial, sustained improvements in clinical and financial metrics as a result of their EHR investments. Similarly, in an Impact Advisors 2015 survey of CHIME members, almost 60 percent of respondents said that investing in an EHR had not helped their organization achieve their productivity and efficiency goals. In short, they had not realized value from their huge EHR capital investment.

Evidence is mounting that winners in the new paradigm of value-based payment will have to succeed in all quadrants of the “Quadruple Aim” by improving quality, decreasing cost and improving patient and provider satisfaction. To attain the full benefit of EHR adoption, healthcare organizations need to change processes, culture, and behavior—innovations for which an operational EHR system is a necessary, but not sufficient, ingredient to create value independently.

In this session, which closely followed the full conference session, “Prove that EHRs Add Value,” we asked CIOs from some of the nation’s leading healthcare institutions to give some examples of how EHRs are providing value to their healthcare organizations as well as to describe some of the primary challenges and barriers for realizing value and the key organizational relationships to ensure success.

Examples of Value Realization Success

We started by asking the group about their experience of value realization from implementing an EHR. Immediately CIOs around the room provided examples of specific use cases in which EHR implementation and optimization provided significant value to their organizations and the patients they serve.

Mark McMath, Methodist Le Bonheur, shared significant work around sepsis that his organization has done. In partnership with Apple, they have developed tools that coordinate with the EHR such that as the patient is being screened for sepsis there is a dashboard tracking multiple measures and an algorithm is used to determine which patients are developing sepsis. An alert is sent to appropriate providers via Apple Watch. The result is that response time for treating patients with sepsis has been reduced from hours to minutes. He notes that similar programs have been instituted across the industry, resulting in hundreds of thousands of lives saved.

Rich Pollack from VCU Health, which uses Cerner as their EHR platform, reports that his healthcare system has been using an early warning system in the ICU. It creates a dashboard to monitor critical data with an algorithm that identifies patients who are deteriorating and alerts the rapid response team. “This has resulted in a dramatic reduction in codes in the ICU as well as outside of the ICU. Prior to the EHR and implementation of these tools the rapid response team relied on caregivers at the bedside noticing the deterioration of a patient and calling the rapid response team, which was much less effective.”

Jim Veline, Avera, reports that drug seekers now have to drive for many miles away from his health system’s emergency departments to get drugs. They have instituted sharing of data across Avera facilities as well as neighboring health systems to clamp down hard on drug seekers as well as identify physicians who are overprescribing controlled substances. They share real-time data on prescriptions written and medications filled via Surescripts. The data-sharing program has been able to bend the curve on provider overprescribing and has significantly reduced the number of drug seekers in their emergency departments.

Baystate Health’s Joel Vengco notes that his systems’ EHR has provided a lot of value to patients. They have implemented Open Notes through the patient portal so that the comprehensive record can get into patients’ hands. He also notes that the EHR has provided in value in many other ways including allowing digital communication with physicians, digitizing prescriptions to eliminate errors and allowing prescriptions to be directly transmitted to the pharmacy.

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