The suggestion to “follow the money” has become a popular, if not clichéd, catchphrase used in movies (“All the President’s Men”) and television series (“The Wire”). Loosely defined, this expression suggests that a “money trail” is a good indicator of motivation and future actions. When the investment money is “followed” among healthcare chief information officers (CIOs) in the foreseeable future, it will likely show that the optimization of electronic health records (EHR) is a top priority for the industry.
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According to a recent KPMG survey of the College of Healthcare Information Management Executives members, 38 percent of respondents ranked EHR system optimization as their top investment priority over the next three years. This trend toward increased investment in EHR optimization is not surprising to two specialists in the healthcare industry.
On the Front Lines of EHR Optimization
Lynne Gratton has spent the last 27 years guiding pediatricians and their staff through the labyrinth of EHR platform implementation. She is a New Client Implementation Specialist for PCC, and helps new and existing clients convert from their old practice management software to the company’s pediatric-focused EHR platform.
The generic term “optimization” is often misused, but as it relates to EHR, Gratton offered this explanation.
“It means fully utilizing the EHR features available to improve patient care and quality of outcomes while doing it as efficiently as possible,” she said. “There are many pediatric offices that aren't taking advantage of functionality of an EHR platform. Our platform can save them time. A good example of this is sending education materials to the patient portal, utilizing patient portal messaging to minimize phone calls and streamlining their electronic chart notes. Another way to think about it: it's about getting your money's worth from your EHR!”
Gratton is also one of the moderators of “PCCTalk,” a mailing list where PCC clients can ask each other questions. This can lead to clarification from PCC on various options for the software for whichever topic has been introduced. It can also point them to the appropriate documentation for changing configuration.
Gratton meets with clients regularly to review how they are using the software, help them become more efficient and expedite patient flow through the front desk of the practice.
“I believe more CIOs and practice managers are planning on investing in optimization because many providers are finding that using their existing EHR platform takes more time than paper charting, which potentially means seeing fewer patients, spending more hours in the office, or at home charting. More providers are trying to make an effort for a ‘work/life’ balance, and optimization should mean a doctor can see an extra patient a day or go home at a decent hour without having to continue working from home.”
What is Driving This Trend Toward Optimization?
Jeffery Daigrepont is a senior vice president at Coker Group who specializes in healthcare automation, system integration, operations and deployment of enterprise information systems for large integrated delivery networks. He is a popular national speaker and is frequently engaged by highly respected organizations across the nation, including many non-profit trade associations and state medical societies.
Daigrepont co-authored a top-selling book, Complete Guide and Toolkit to Successful EHR Adoption, published by Healthcare Information and Management Systems Society (HIMSS) in 2011 and was a contributing author to Coker Group’s book, The Healthcare Executive’s Guide to ACO Strategy, published in March 2012. Daigrepont explains the drivers of this trend toward optimization.
“Medical practices are now beyond the initial challenges of getting an EHR platform installed,” he said. “This process of going from paper charts to electronic data was a significant accomplishment and now practices are making decisions about the ‘next steps’ in this process. Optimization is the next logical step. The change in the ways hospitals and physicians will be reimbursed – the trend toward value-based healthcare – is also causing an emphasis on the efficiency of data collection.
“CIOs view optimization differently than physicians. A CIO is seeking more efficiency for the entire system. Whereas, a physician is more concerned with treating more patients with less time spent on data-entry.”
The Advantage of a Pediatric-Specific Platform
The PCC platform is pediatric-specific, and Daigrepont sees this attribute as an advantage for optimization.
“The Coker Group has a policy of not investing in companies we evaluate for our clients in order to avoid any conflicts of interest,” he said. “That being noted, we really like the fact that the PCC platform is tailored specifically for pediatric practices. The company’s product meets and exceeds our expectations.
“It is well-documented that a pediatrician on average will see a patient every ten minutes, and, if it takes two minutes to document the patient’s health records, that is the equivalent of 20 percent of their examination used for EHR. There are several ways that EHR optimization can help reduce this time.”
The PCC platform is designed for maximum optimization. Gratton explained.
“There are many ways the PCC platform helps with this process. First, we allow the practice to configure its protocols and templates to best meet the workflow of patients through their office. Our protocols have the AAP's 'Bright Futures' baked in, for example, so when a doctor selects a well visit, the appropriate orders, questions, and developmental patient guidance for each patient's age are right there at the doctor’s fingertips.
With this system, a one-year wellness visit can include all of the immunizations typically given at this visit along with the Bright Futures anticipatory guidance and patient handouts! The real-time clinical decision support for tools like the childhood immunization schedule or calculating the date due for the next physical seem like little things, but they add up for pediatricians.
Daigrepont added, “Without a doubt, the PCC platform is intuitive to the unique nature of the pediatric environment. As I noted earlier, the volume of a pediatric practice is much higher than any other specialty, where a pediatrician will examine 30 to 40 patients a day. To add to this challenge, pediatricians are one of the lowest paid providers. Thus, when their productivity is compromised, their incomes are disproportionately affected.”