For EHR Implementation, the Time to Act is Now
Guest commentary from Thomas L. Pettibone, founder and managing partner of Transition Partners.
President Obama's economic recovery package allows for billions of dollars for health care IT investment. As the recovery package begins to be distributed, hospitals and health care providers have significant monetary incentives to demonstrate "meaningful use of certified electronic health record (EHR) technology."
The benefits of EHR systems are numerous. However, for those organizations that want to maximize the amount of stimulus funds received, the time to begin the transition is now, as EHR implementation is a long and challenging road.
In order to encourage hospitals to make an early switch to EHRs, the millions offered in incentive payments will incrementally decrease the longer a hospital waits to adopt the electronic system. Hospitals that implement the EHR system within the first three payout years (2011 - 2013) will receive the maximum funds, each year thereafter decreasing by 25 percent until eventually funding disappears.
Hospitals will also be penalized for not making the switch to EHRs with decreased Medicare and Medicaid reimbursement. For example, if an organization is not EHR-equipped, it may only receive 95 percent reimbursement, versus the 100 percent reimbursement that an EHR-equipped hospital might receive.
While there's certainly some resistance among the health care community in implementing EHRs, we must realize that electronic record keeping is certain to become standard given the administration's focus and the direct involvement of heavyweight corporations such as Wal-Mart.
As hospitals and health care providers grapple with rapid advancements in technology, the new breed of doctors that grew up in the Internet age choose to work for institutions that employ the most modern and up-to-date communications and EHR systems. So, another major benefit of EHR technology is its influence on attracting and retaining the best talent.
Beyond all the benefits for hospitals, an EHR system has a real life-saving potential. EHRs allow for not only the rapid transfer of information from physician to pharmacy but also the ability for medical professionals to access records simultaneously, reduce errors and cross check prescriptions for contraindications. Especially during emergency situations, easy access to records can make the difference in life-threatening situations. Soon, EHRs will enable paramedics to access patient records, on-site, in real time, identifying any pre-existing conditions or allergies to medications.
Finally, by avoiding multiple entries, EHRs can increase efficiencies and streamline operations, allowing hospitals to shift focus from heavy clerical tasks to more mission-critical tasks.
EHR implementation, depending on where a specific organization is in the transition process, can take 2-3 years. Therefore, it is critical to take the right steps toward implementation now in order to receive maximum stimulus funds and ensure a smooth and timely transition.
In essence, EHR implementation is a six-step process. The first step is an initial assessment of a hospital's existing infrastructure and data to determine its quantity, quality and age. Patient records must be up-to-date and consistent throughout the hospital prior to the transition to ensure a flawless switch.
Once the infrastructure has been assessed, the future state of the hospital must be defined to answer the question: Which best practices need to be implemented for this particular hospital system?
A gap analysis will then define what will need to be upgraded or reformatted to interface each system into the future state, followed by the development of an overarching strategy to close the gap.
Once a strategic plan is in place, the next step is to build a business case that includes the cost of the implementation, time needed for completion, long-term payback and any other advantages or disadvantages to be realized through the implementation.
Lastly, the longest and most challenging step is the implementation, which will involve implementing both the technical specifications of the envisioned system as well as the business process to enable the desired shift. This stage includes vendor analysis, hardware and software implementation, and building custom software for the institution. All the appropriate business processes need to be in place in order to convert to a new EHR system.
Normally, hospital IT departments are not staffed to implement new, large initiatives such as EHR systems. They are staffed to address the critical day-to-day issues necessary to keep the hospital running, so a smart way to expedite the implementation is to use an outside party to oversee and manage the process. This will allow for an uninterrupted process of assessment and plan development for the hospital, without any internal distractions. This is a relatively small expense for a dedicated team that is unbiased and unburdened by constituencies or existing projects, either of which can delay getting an EHR system up and running.
With the first stimulus payouts beginning in 2011, putting EHR implementation on the back burner will only hurt an institution. Delaying lets the competition race ahead and diminishes the financial incentive. Start today. It makes financial sense, and more importantly, helps patients.