Partners Healthcare, has recently reported they “expect a $200 million hit to profits over three years from expenses tied to implementing the new electronic health record (EHR) system.” The EHR in question is Epic. While I cannot speak to this implementation specifically, I have seen this same problem at the other eighty or so organizations I’ve investigated. These organizations were able to mitigate most of these financial losses, rapidly turning them gains following an Epic installation. Take advantage of the features of your new EHR to recover the expense of its implementation.
Some losses are expected following a large enterprise EHR roll-out. The newly installed EHR is unfamiliar to end users. For large scale Epic implementations a reduced patient schedule is absolutely necessary to maintain patient satisfaction and physician sanity. This is the strategy that Epic endorses and Partners employed for their implementation.
There are a number of actions any organization can take when faced with the challenges of year-over-year losses related to the implementation of an EHR like Epic. I’ve broken up the challenges into a priority based on opportunity cost. Your mileage may vary.
Minimize schedule reductions prior to Go-Live by:
- Train physicians to use EHR with specialty focused content.
- Train physicians in basics before go-live and in efficiency tools several weeks after go-live. Advanced features come much later.
- Minimize system distractions by only having content physicians need to see on the screen.
Following Go-Live make sure you:
- Produce robust financial reports – this is your guide book to future changes.
- Reduce claim denials – through proper E/M coding, documentation, and diagnosis setting.
- Capture all charges – through a charge capture activity or automatically in your native ordering system.
- Make it easy to close encounters in a timely fashion, and encourage your physicians to do so.
After your organization’s EHR is stable, ensure you:
- Keep your referrals in house through a guided referrals system.
- Eliminate excess readmissions as defined by the ACA (For example: Partners Healthcare is estimated to pay out $1.2M in penalties for 2016 based on government reporting!).
- Reduce hospital acquired conditions penalty leveraging your shiny new EHR.
- Improve patient portal and enable e-visits to improve access to care.
- Address care access metrics and reduce patient wait times.
- Optimize your EHR for each specialty.
- Reduce variation in care.
Advanced organizations then:
- Build chronic disease registries and an outreach program around these disease metrics.
- Improve chronic disease metrics with specific quality improvement projects.
- Setup physician approved protocols for nurse triage and prescription refills.
- Structure your IT team around departments and not applications.
While many of these projects have challenges and take time to complete, addressing each of these will enable your organization to avoid or mitigate many of the losses related to the installation of a new EHR.
I’ve helped organizations in each stage of development achieve these goals and have seen the results of their labor. I’ll be detailing each problem, solutions, and benefits on my blog. Let me know which challenges you are facing today and we will start there together.