Addressing EHR Rollout Problems

EHR rolloutsTo say that there are certain people in the medical industry that are resistant to change, especially when it comes to technology, may be an understatement. But with new regulations and rules coming our way, many hospitals, doctors offices, and providers have been forced to upgrade and embrace new technology or pay the penalty. In addition to avoiding penalties, there are also cash incentives available to practices that upgrade to and meaningfully use electronic health records (EHRs). But are these incentives actually causing problems with EHR rollouts?

Let’s take, for example, a recent case that occurred at the Athens Regional Health System in Georgia in which the CEO resigned after an aggressive and rushed EHR rollout. Staff and clinician’s basically came to a ‘no confidence’ vote for the CEO after the rollout created medication errors, scheduling problems, misplaced orders, and general disorganization. Management then turned and placed the blame squarely on the their own IT department for not following proper decision making channels.

In another example, a Maine Medical Center is claiming their EHR rollout is partially to blame for a $13.4 million operating loss. Nurses cited a lack of training and stated they were unaware that they were responsible for charging patients for procedures and that they weren’t even trained on how to charge with the new system. Therefore the blame was on the company that installed the system, according to the medical center.

So as in any instance where things go wrong the question is always, who’s to blame? Is it the CEO who aggressively tries to implement new procedures trying to take advantage of cash incentives? Is it the staff that are resistant to change and fail to apply themselves during training? Is it the IT company that installs the system and is responsible for training team leaders and employees on how to use the new system?

In a large amount of these cases, the blame seems to go in a circle. The staff blames management, management blames IT, IT blames the staff. In the end, everyone is affected from the hospital or medical center losing money down to the patients who don’t receive the proper care.

But if we step back and look at the big picture, the truth is that everyone is partially to blame and everyone is responsible for righting the ship. Technology rollouts are not something anyone should take lightly and preparation is key to make sure everything goes smoothly. All the decision channels should be determined before an IT company even starts to implement changes.

While we have highlighted some of the problems with EHR rollouts, there have certainly been a number of success stories. Many providers have successfully implemented new systems and are benefiting from quicker access to patient data, easier methods of sharing information, and better ways to track costs and bill patients.

Delays in new regulations are giving providers more time to make changes and providers would be wise to take advantage of the extra time. Additional training for employees and better testing of systems before they are set in place can help insure a smooth EHR rollout and ultimately help provide better care for patients.

Understanding Meaningful Use

For those outside the health care industry, you may not be familiar with the term ‘meaningful use’ in conjunction with health care. According to www.cms.gov, “Meaningful Use is a a set of criteria for the use of EHR (Electronic Health Record) systems to improve patient care by health care providers”. The end goals of meaningful use include improved population health, coordination of care, improved safety, and patient engagement. In an effort to motivate providers to implement meaningful use, incentives were established by the HITECH (Health Information Technology for Economic and Clinical Health) Act for adopting Meaningful Use criteria starting in 2012, with the possibility of penalties for failure to achieve the standards by 2015.

So, in more basic terms, in order to receive incentives and avoid penalties, provider must prove they are “meaningfully using” their EHR technology by meeting certain thresholds established by the Centers for Medicare and Medicade Services (CMS).

But meeting this criteria is no easy task. The program includes three stages providers must complete in order to receive their incentives, each with increasing requirements. To begin, providers have to meet requirements for a 90-day period in their first year, then meet Stage 1 requirements for the full second year. Starting in 2014, they can move on to Stage 2 requirements which must be met for two full years. Stage 3 will start in 2016. Whether you participate for a fiscal or calendar year depends on the type of provider you are.

While the participation is challenging, the rewards are significant. As of Feb. 2014, CMS says it has distributed more than $19 billion dollars in reimbursement incentives. Over 440,000 providers are participating with approximately %88 receiving incentive payments.

The program is on track to achieving its goals, according to recent surveys. There has been significant increase in the use of EHR systems by office-based physicians, with nearly 80% of offices using some sort of EHR system in 2013 according to a National Ambulatory Medical Care Survey. But most importantly, over 78% of respondents said that EHRs “overall, enhanced patient care” was a clinical benefit to increased use EHR systems.

For more information on the requirements of the meaningful use program, we encourage you to visit http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html.