Most of us only use our personal computers for basic functions. On occasion, a more experienced user may teach us an obscure but useful trick, which causes us to think, “How much of this program am I not using?”
It’s a classic case of learning something in survival mode. When we are pressed for time and by outside forces, we’re likely to learn just enough to get by.
However, that’s a big risk when it comes to implementing electronic health records (EHRs).
Provider margins have been under pressure for years, and there are few extra resources available to teach staff new applications or to staff up while users’ productivity falls as they begin using new software. However, with mission-critical applications like EHRs, it would be short-sighted to force users to learn applications in survival mode. It’s a profound waste of resources and investment to not take advantage of the full capabilities of these systems.
Achieving a return that makes a difference will take more than an initial investment of money. An EHR by itself will not provide the type of analysis and intelligence that healthcare organizations need to improve quality and reduce costs. Other IT investments will also be needed, such as enterprise data warehouses (EDWs) and analytics applications. Leaders also need to give their staff enough time to achieve measurable results from clinical IT systems.
A recent CHIME case study (available at chime.org) details the steps that Texas Children’s Hospital in Houston had to take to gain meaningful performance improvement with the data in its EHR. When the facility first implemented its EHR in 2008, clinicians complained that they could not easily extract the knowledge they needed from the data. “That was the ‘aha moment.’ You can’t underestimate that the EHR is not a silver bullet, that it’s only the beginning of the journey,” said Myra Davis, its senior vice president and CIO.
Texas Children’s Hospital implemented an EDW solution in September 2011. Then IT staff and clinicians started working in cross-functional teams, using new analytics applications that enabled them to better visualize results in minutes.
Data is now informing performance improvement efforts for asthma, pneumonia, spinal surgery, and other care areas. Texas Children’s executives estimate they have achieved about $4.5 million of direct benefits from only four of its EDW projects.
As the federal government’s meaningful use initiative has progressed, expectations are high that providers will not only implement these systems, but increasingly use the information they contain to improve care and reduce costs. However, the time constraints of the federal program—which measures compliance by certain predetermined deadlines—leaves little wiggle room for providers to get beyond the basics.
CHIME and many other healthcare organizations wrote a letter to the Department of Health and Human Services (HHS) in February, expressing concerns that the nation’s hospitals and physicians need additional flexibility in the current deadlines in the meaningful use incentive program. Soon after, HHS released an exemption process for providers that have EHR vendors that are behind schedule. CHIME continues to work toward achieving more federal flexibility that will enhance opportunities for the nation to maximize the investment in EHR technology.
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