Diagnosing, optimizing, and funding your next EHR implementation to combat provider burnout

The current healthcare landscape is challenging as costs continue to rise across the industry, with experts predicting an additional seven percent increase next year. Additionally, hundreds of hospitals, especially in rural communities, are at serious risk of closing their doors permanently, which not only impacts access to quality care but a primary employment source for the community. 

Providers are at the heart of this issue as they’re responsible for care delivery – hospital, ambulatory, and virtual – so it’s concerning that so many are burning out and losing faith in the system. Adding to this challenge is a wave of healthcare practitioners (HCPs) retiring and fewer young people choosing to enter the medical profession. According to Bain and Company, 25 percent of physicians and nurses plan to leave the healthcare field, identifying burnout as the primary driver.

With the average physician spending over eight hours per week on administrative tasks while being asked to see 20 patients a day on average, it’s no wonder they’re dissatisfied with their professions. Unfortunately, one of the tools that was created to address this issue and drive a more integrated and efficient administrative experience—the electronic health record (EHR)—often exacerbates the burden on HCPs.  

This epidemic of burnout can impact a variety of business imperatives from recruiting and retention efforts to appropriate claims submissions for revenue collection—all of which can ultimately lead to critical problems like delayed care, suboptimal quality of care, and patient safety issues. Clearly, it’s time to evaluate solutions and act. The EHR is the perfect place to start.

Diagnosing the problem: Assessing your EHR build and workflow  

While most EHRs need some level of optimization, most do not require a complete overhaul of the system. The first step is understanding your organization’s specific pain points and what is required to address them within your unique instance. There are two tactics organizations can first undertake on their own before bringing on a strategic partner.

First, it’s important to lean on the governance structure that exists within the organization, liaising with its physician advisory committee, nurse advisory committee, informatics teams, and other similar groups to identify pervasive issues that clinical users are having with the EHR. Having an IT representative at the table in these conversations is also critical to identifying the root of the problems clinical staff members are experiencing.

Without this type of governance structure, it’s likely teams are treating the EHR as only a technology and not a workflow enablement tool. By not providing the EHR with the necessary staff involvement and oversight it requires, many organizations begin to run into issues.

Second, most EHRs have reporting functionality that shows data such as the amount of time a physician spent updating charts or on other administrative tasks. This quantitative data, coupled with qualitative feedback from committees, can help pinpoint exactly where the EHR is failing users:

  • Is it a workflow issue?
  • Are the systems being updated with the latest software?
  • Is there a lack of adoption in your organization?
  • Is new or refresher training needed for specific workflows or in different departments?

While each hospital or health system scenario is unique, there are three common upgrades to EHRs that make a significant dent in the administrative burden that drives burnout and dissatisfaction among clinical and administrative staff. 

Scenario #1: Assess available optimizations from the EHR vendor

After dedicating time and resources to the initial launch of a new EHR installation—whether it’s Epic, Oracle Health, or MEDITECH—many organizations struggle with ongoing maintenance. Because their internal IT teams have limited bandwidth, it’s challenging to stay on top of new features and functions.

Like a personal laptop or iPhone, each new EHR upgrade or product release requires evaluation:

  • Will the new features have unintended negative downstream effects?
  • Is it best to install an update as soon as it’s available, or is it better to wait?
  • Are opportunities for automation appropriate for the organization?

Answering these and other questions can be a daunting task that leads many organizations to abandon updates. However, it’s incredibly important to take advantage of new functionality and understand the value-add for EHR users. While the vendor’s support team can absolutely help, bringing on a firm means that the hospital or health system gets the benefit of key learnings across a robust client portfolio. 

Scenario #2: Assessing specialty solutions that did not go live at the EHR launch

In many cases, once an organization begins looking at standard updates, implementing specialty solutions that were not included in the initial system launch becomes a consideration. Oncology and anesthesia, for example, represent two common specialty solution units that are assessed for optimizations to drive efficiencies and provide a more seamless patient experience. 

A recent example of this is the work our team did with a health system in San Diego. Despite having had an EHR in place for nearly a decade, until recently the organization’s anesthesiology department was still doing its documentation on paper.

Pushing the anesthesia unit live in their EHR was incredibly helpful and has already taken a huge burden off the anesthesiology team. The efficiencies this optimization created include:

  • Allowing the team to spend more time with patients and less time on administrative tasks
  • Allowing for improved charge capture, streamlining the flow of revenue
  • Improving patient safety through real-time drug interaction and allergy checking
  • Improving access to patient clinical documents

Scenario #3: Mergers and acquisitions

The last need for optimization support is typically found in M&A situations, which have become increasingly common in the provider world. Integrating an absorbed hospital’s information into the larger organization’s existing platforms is a major undertaking that will likely require IT support beyond what an internal team can accomplish.

Here are key questions to ask as the team considers its assessment: 

  • Is the team aligned on application rationalization – what aspects stay, which ones go, and why?
  • Do all the individual hospitals need to be on the same EHR platform? 
  • Can data be shared between inpatient and ambulatory settings? 
  • How do we ensure the systems are interoperable to ease logistical headaches? 

A children’s hospital recently acquired another hospital in their region. Nordic managed the planning and rollout of the EHR implementation for the absorbed organization to ensure the transition went smoothly. In scenarios like this, it’s important to have a partner who has clinicians on staff who know firsthand what the challenges are across the EHR, allowing them to hone in on solutions faster and more effectively.

Funding your EHR optimization projects: Taking the long view

If you’re going to address the clinical challenges in your EHR, consider tackling revenue cycle optimization at the same time. There are financial benefits to pairing these optimizations, including helping fund the cost of your EHR work.

As a full-service health IT firm, Nordic often works with organizations on end-to-end EHR optimizations – across clinical and revenue cycle operations. We have seen great success in achieving net revenue improvements and then pushing the funds collected to the type of clinical EHR work described above.

These optimization projects assess where you may be able to reduce avoidable write-offs, identify expense reduction, and look for efficiencies to boost your bottom line. While streamlining your revenue cycle often takes several months to materialize, it may include both net revenue and cash flow. Common revenue cycle improvements include:

  • Capture of missing charges
  • Documentation improvements that support appropriate reimbursement
  • Workflow automation that reduces manual touches
  • Workqueue redesign that prioritizes accounts based on revenue and collectibility
  • Timely patient estimates and patient collections

Time to invest in your organization’s future

By making this valuable investment in your organization's future, you’ll find it’s easier to recruit and retain top-tier staff, empowering them with the technology necessary to make more informed decisions while simplifying workflows to keep them engaged.

In turn, you’ll attract more patients by delivering a quality experience that reduces hiccups like incorrect documentation. Whether you need a completely new EHR implementation, extension, or a specialty unit rollout, there’s a range of options to create vast efficiencies in your operations while protecting and boosting your bottom line.

Topics: Implementation

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