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The last decade has seen an explosion in the quantity and sophistication of tools designed to enable every participant in the health care delivery system to make strides in achieving the Triple Aim: lowering cost, enhancing quality of care, and improving outcomes. However, one tool is central to achieving the Triple Aim – the Electronic Health Record (EHR).
It is impossible to achieve the Triple Aim goals without the right information. An EHR gathers the most important data and structures it so it can be aggregated, analyzed, and exchanged. EHRs ensure the most critically important information is recorded and enables that information to be used to make better care decisions, which are crucial to enhancing the quality of care. Better care decisions will lead to better outcomes. And better care and better outcomes reduce costs.
EHRs enable health information to be accessed at the point where it is needed. This is dictated by the goal — care delivery, population health, and cost control. A robust EHR will allow the necessary information to be sent to the appropriate place — a provider, public health department, researcher, or others. Prior to the adoption of EHRs, there were limited means to ensure information was available where it was most needed. Today, EHRs enable information to be seen and considered by those whose decisions depend most on accurate information.
EHRs also enable health information to be available when needed. This will provide for better care delivery as well as better outcomes — not only for patients, but for our health care system as a whole.
The Oregon health care community has one of the highest rates of EHR adoption in the nation. Just implementing an EHR, however, will not achieve the Triple Aim. Providers must optimize the use of these tools in order to reap the benefits they promise. Oregon’s providers are moving toward becoming meaningful users of their EHRs — a legal standard that is required to qualify for CMS EHR Incentive Payments. Meaningful Use (MU) ensures that providers are using their EHRs in a way that will maximize the potential to achieve the Triple Aim.
Since the enactment of the HITECH Act in 2009, the number of vendors and products that meet Stage 1 MU certification requirements of the Office of the National Coordinator for Health IT (ONC) has increased exponentially. A provider looking to implement a new EHR faces a daunting task not only in choosing a vendor, but matching the practices needs to a particular product offered by that vendor.
[See also: CMS EHR incentive payments surpass $5 billion.]
Of course, not all EHRs are created equal. Many are perfectly adept at meeting Stage 1 of MU. But the later stages of MU are more difficult to meet, and the EHR products will require updates and changes in basic, as well as advanced, functionality. These products will need to be more interoperable and able to integrate into pre-existing systems. A small, poorly funded EHR vendor may have trouble keeping up with the increasing functionality demands, especially on the tight timelines dictated by the CMS EHR Incentive Payment program.
Choosing a well-established vendor with the organizational strength to innovate quickly and effectively may prevent headaches for the practice as they progress down the timeline. Choosing a product that has proven its capacity to handle more advanced functionality at the earlier stages may seem like overkill, but it ensures that the later, more difficult stages will not pose serious problems for the practice.
Practices will benefit greatly from consulting support during the product selection phase. A successful implementation begins with choosing the product that best meets the needs of the practice and its employees. The entire staff will rely upon the EHR to do their jobs—and each segment of the staff should be represented in the choice of the product.
The key to choosing and optimizing an EHR is articulating three to five features that are most important to a practice, and then to understand the pros and cons of using this criteria to choose a product. For example, if price is truly one of the most important features for a practice, then that practice should recognize what is given up when choosing a less expensive product. By understanding the pros and cons of each feature or criteria, practices can make the most informed decision possible.
Previous articles from the OHN series: