How EHR implementations are getting more creative

In the 1930s, Nestlé had a problem: Thousands of pounds of coffee beans were sitting in warehouses in Brazil, driven by a surplus in beans and sales declines from the Great Depression. Nestle needed a way to preserve the coffee – and out of that problem came the invention of instant coffee, marketed as Nescafé starting in 1938.

The healthcare industry is in a similar period of creative innovation. Budgets are tight, and good outcomes are critical to reimbursement. With the industry changing, healthcare organizations are becoming more creative in the way they align technology with care, and that extends to EHR implementations.

Watch this video to see Sheri Long, an Advisory Services consultant with Nordic, chat with Practice Director Josh Kalscheur on how industry changes are driving more creative, fiscally responsible EHR implementations.

Josh: Hi everyone. This is Josh Kalscheur, Practice Director over our Advisory Services team here at Nordic. I'm here today with Sheri Long, one of our Advisory Services consultants. I want to spend a little time talking about some industry trends. 

Sheri, you work in clinical informatics, have been in the industry for decades and have a ton of experience in both caring for patients and working in the IT space. I would love to talk a little bit about some of the things that are going on in our industry right now – some of the big changes and how we can imagine our world in this Epic space. What are some of the things that we can be doing to prepare and provide the most value in that space?

I wonder if you could give just a quick overview of who you are and some of the work that you do.

Sheri: Sure. I'm Sheri Long; I'm a nurse. I've been in clinical informatics, in association with nursing, for – just say over 20 years. I don't want to be specific.

Josh: Sounds good.

Sheri: I've seen a lot of industry changes. I've seen a lot of patient care changes. I see a lot of reimbursement changes. As we've watched value-based medicine take the center stage, what is changing is how we accomplish the goals that value-based medicine insists on us having. Luckily, with Epic and Epic implementations across many health systems, it's become much easier because of their awareness and the designs that the hospital uses. Understanding their internal goals, as well as the capability of Epic. They make it easier every single time to accomplish the things that we need to get top reimbursement in pretty tight times right now.


Josh: I think what's interesting and that I've noticed over time is that the software itself, though it certainly has plenty of room to grow, generally is either meeting or exceeding the needs for some of those reimbursement changes. The difference often tends to have a bit more to do with that organization and how far along that path they may be, or what their larger vision is for where they may be going and what they may be doing.

I'd be interested to know from your perspective and from what you see, project by project: Have you seen a difference, in regards to how the software itself is installed or used by organizations in response to some of these regulatory changes, and as we're moving more towards that value-based care model?

Sheri: Yes. From my personal observations, I’ve seen a growth trend with operations, knowledge of what they need to do, and Epic, as a leader in the industry, anticipating those needs and being proactive about developing ways to meet the needs. Every time we install or we go up with another version, those lessons learned are incorporated and then cross-trained to operations, while at the same time, operations is informing their Epic partners on what they need for the next steps. It's almost like this great energy that helps each other move forward along that path. That seems to be the difference. That trusting relationship that happens is a trend. Obviously since more Epic installs are happening, there's more customers on Epic that realize that kind of companionship.

Josh: I'd be interested to know from the work that you're currently doing. You're in the midst of an active implementation right now.SheriLong_IndustryTrends_Photo-1.jpg

Sheri: Yes.

Josh: Right now, there's plenty of talk going on in regards to a shift away from the ACA model into what's currently dubbed the AHA model. There’s certainly plenty of swirl in the industry and politically about that. I do wonder if you're seeing any shifts on the ground, on site. Is your client changing the way that they're implementing? Are things slowing down or speeding up? Is there any of that that's actually affecting things that are in progress right now?

Sheri: The biggest thing that I see is how they accomplish it. When you have a product that you know is the best, you want it. Everybody wants to do the very best for patient care. We want to have the best electronic health record. We want to have the best patient experience for the whole health system, not just the hospital. They don't want to compromise on the quality of anything, but they're beginning to get creative about how they want to implement it. In the past when they would want to just put everything up at once, now they're trying to be a little bit fiscally responsible and picking and choosing what components they think are best to implement and then later come back in.

It has a dual opportunity. One, they can manage the debt that's associated with that type of quality implementation. They can also manage the changes that happen, in order to react to what they implemented, as well as prepare for what's coming next. They're able to identify workflows that they can solve, as they examine the pieces in order to do only parts.

It automatically causes a little bit of granular review of some stuff. There's benefits to that. They're able to manage the cost in a way that feels more responsible to their demographics. I think that's really what I see changing the most, is how they approach doing it. They don't want to not do it. They just want to do it wisely.

Josh: I appreciate that. I think one area where I feel like we may be seeing that – and with your clinical background, I'd be interested if this matches what you see as well – is Home Health. Home Health is an area we continue to hear a lot about and expect more from, with the changes in demographics and Baby Boomers aging and what not. I have not seen the number of implementations come through the door that I think I would expect to see, given the changes.

Sheri: Of the Home Health module?

Josh: Yes. I'm wondering if that matches your experience as well. Do you see most organizations holding off on Home Health and putting it off as one of those things we'll do down the line? Or are organizations figuring out a different way? What has been what you've seen?

Sheri: I definitely have seen what you're saying. I think there's a reason for it. Every hospital has a forte. Every hospital has something that they do really well. If it's an area with population management and population health management, they're going to be very proactive about bringing on the Home Health module because they understand the impact that that would have. Some of the other areas that are focused on surgery tend to let that lag behind for the moment. They always want to incorporate it, but it really depends on what the focus of the actual facility is. That dictates when they think it's the most important for their clients.

Josh: The last thing I'd like to chat a little bit about is the mergers and acquisitions and consolidation that we see in the marketplace right now – a very common thing we see across a number of different markets and a lot of different organizations. I think it's a trend that we certainly expect to continue: continued consolidation and organizations looking to broaden their patient base in order to provide them with the best fiscal model and the broadest reach. Based on what you've seen and what you're seeing in the industry, does that match your expectations as well? Is that a path that you see continuing to happen, even with some of these continued regulatory changes and what not?

Sheri: It is. I think it goes back to what we talked about earlier. It's another creative way for them to get the absolute best tools to deliver healthcare. Sometimes you partner up to reach a goal. That's what I see as just another facet of that same end result. Not only that, but I think that smaller hospitals look for the guidance from larger facilities that have more intense care. It's a benefit to both. The smaller place ends up getting really, really good tools, like we talked about a minute ago. They also contribute to the population. They're able to work together to create a larger, broader-reaching way to make sure that patients are taken care of. I think it's just another creative way that we're going to do that same thing.


Josh: I think that's fair. I appreciate that. I definitely appreciate your time to gain some of those perspectives. That's been really valuable.

Sheri: Thank you.

Josh: Thank you. I certainly hope that this has been an opportunity for you to get a little bit of an insider's perspective on what's going on in health care IT and in the Epic space right now. Appreciate it.

Sheri: Thanks. Glad to be here.


Topics: implementation planning, value-based care, mergers and acquisitions, Epic Community Connect, Implementation, Advisory

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