HIMSS 2017: EHRs are advancing 'with you or without you'

Healthcare leaders are confident their organizations will realize the full benefits of electronic health records (EHRs), while warning clinicians resistant to new technology to either take advantage of training opportunities or get left behind.

The survey, conducted by HIMSS Analytics and Nuance Communications and announced at HIMSS 2017 in Orlando, was completed by 167 respondents in 142 organizations. Roughly 40 percent of those who participated hold C-suite titles, while another 40 percent serve in IT leadership roles.

Some 80 percent of respondents expressed confidence their organization will realize “the full benefits” of EHRs, including improved coordination of care and patient outcomes and significant investments in training, extra IT staff and support.

Now, they’re planning on adding additional technology to their EHRs. For 2017, 25 percent of respondents said they’ll introduce enhancements like mobile devices and apps, computer-assisted physician documentation (CAPD) and speech recognition software.

“Now that we have systems with burgeoning reams of data, the key will be extracting and abstracting meaningful information and knowledge out of the raw data,” said John Lee, MD, CMIO of Edward Hospital near Chicago and member of the HIMSS Physician Committee. “We must then use this knowledge to truly improve care.”

Getting clinicians to actually use these additional tools remains a challenge; 83 percent of organizations reported that at least three-quarters of its clinical staff was using EHRs to document patient care. But 61 percent reported less than half their clinicians are using mobile applications. Usage rates were lower for speech recognition (44 percent said less than one-quarter of clinicians used it) and CAPD solutions (67 percent said less than a quarter of its clinicians used it).

Some facilities are ahead of others, according to the survey. For example, Hartford HealthCare CMIO Spencer Erman, MD, said before adopting speech recognition software, Hartford Hospitals was dictating and transcribing 4,200 consult notes a month. After adoption, it was down to 207.

Outside physicians, however, may be holding back wider adoption of technology over paper documents. Erman said 30 to 40 percent of doctors outside its system still send in physical copies of consult letters or pre-op orders that have to then be transcribed into an EHR.

“In the hospitals and offices, it’s EHRs only. No paper charts are being kept anymore except legacy stuff. No paper orders,” Erman said.

The new technology has meant new priorities in staffing. Increased investment in areas like software integration and development has led to reductions in other jobs, like in-house medical transcriptionists (down 69 percent) and paper records administrations (down 57 percent).

Training, whether web-based or in a classroom, has been deemed necessary in this transition. Erman said clinicians have to learn to use these tools, noting younger healthcare professionals will be coming in having never used paper records.

“The car—and by that I mean EHR technology—is going down the road. You can drive it, be a passenger or be dragged kicking and screaming behind it,” he said. “The car’s going with you or without you, so I recommend you embrace it at whatever level you desire.”

For executives, the financial impacts alone make adopting new technology essential. When asked what has been the most significant financial benefit, 67 percent said capturing appropriate reimbursements, 54 percent said a reduction in denied claims and 52 percent said improved performance under bundled payments.

“As we’re moving toward value-based care and complete accountability for a given population’s overall health, without systems like these and key tools around clinical decision support … we won’t be able to succeed,” said Michael Hyder, MD, MPH, CMIO of New Bedford, Massachusetts Southcoast Health. “There’s no option not to participate in something like this or to move forward without these types of tools. Advanced information technology is absolutely critical to providing high-quality care at an appropriate cost.”