One of the main purposes for many of the new regulations in the HITECH Act and the push to increase technology utilization within the health care industry is to save money. If implementation of an EHR increases the amount of time to see a patient, is it saving money? What is the real ROI for the average provider post implementation?
My argument is by no means to stop the push for EHR and other technology improvements to the health care industry. My argument is the current players simply do not have the right EHR system to do the job. The majority of systems do not improve workflow or increase efficiency within an office. These systems definitely improve quality of care and decrease the possibility for human error, but do they actually save time and increase the doctor’s ability to perform timely and cost effective health care.
Technology generally improves a person’s quality of life. User interface design is big business. Other software developers focus on ease of use, number of clicks, user intuitive screen design. Business intelligence, finance, security and other very high tech industries have very efficient and easy to use systems. Health care does not. Health care is 10 years behind the curve.
Where is the EHR system that will anticipate the user’s actions based on previous click and role? Where is the EHR system that reduces the number of clicks compared to a comparable system by half? Where is the EHR that allows a physician to double the number of patients they see?
August 5th, 2009 at 6:41 am
Interesting questions:
- Learning from failures in other areas;
- Involving physicians (not only IT manager) in the analysis and design;
- Making education: white papers, conference, university courses.
“Sorry for my English”
September 8th, 2009 at 12:52 pm
I think that your argument is flawed because you are looking at it only from the perspective of directly increasing provider efficiency. If you take a step back and realize the work involved in using paper charts on a day to day basis, you can’t help but improve efficiency even witha mediocre EHR, assuming it’s properly implemented.
Chart management takes a great deal of effort in most offices, including pulling and prepping charts, delivering charts to providers, having providers review the chart, and assuming all the pertinent information has been added to the paper chart because there is no automated audit trail.
I spend a great deal of time in Ambulatory clinics and probably 60% or more have fair to poor chart management systems. While it’s true that it takes time and effort to manage charts electronically as well, you have technology on your side in this case because you have audit trails, automation, etc.
The cost of patient care can be drastically reduced if you look at it holistically rather than just whether or not it makes the providers more efficient. Charts are expensive, FTE headcount to manage charts is expensive, and the cost of mis-prescribing, or mis-diagnosing because you don’t have what you need in the chart is expensive.
Here’s a very simple example of how a good EHR saves money: If you prescribe a medicine that gets recalled, and you need to contact your patients, on paper you have to go through EVERY chart to see if you’ve prescribed said medication. With an EHR you can quickly search the database and get an accurate and complete list of patients on the medication. The time savings here is substantial and goes directly to the bottom line of the provider.
EHR does save money and make the office more efficient if it’s properly implemented and the provider AND her staff are motivated to take full advantage of the system and what it offers.