Physician dissatisfaction with EHRs has been well-documented in recent years, as has the growth of the EHR replacement market. In Kalorama Information's report, The State of the EMR Market in 2017, the authors estimate that approximately 15 percent of physicians are seeking EHR replacement systems in order to mitigate frustrations with awkward and non-intuitive interfaces and functionality gaps.
Ambulatory physicians are particularly driven by the desire to address new quality tracking and reporting requirements under the Medicare Access and CHIP Reauthorization Act (MACRA). A provider who fails to meet MACRA targets could face as much as a 9% reduction in Medicare reimbursements.
Along with meeting regulatory requirements, physicians want solutions that support interoperability with other systems and provide workflows that are efficient and enhance productivity.
For a practice struggling with its existing EHR, how do physicians and staff know when the time is right to walk away from their current system and seek a replacement? More importantly, what can a practice do to avoid past selection mistakes and make sure its next EHR satisfies today's needs, as well as future requirements?
Evaluate Objectively
Before a practice abandons its existing EHR, physicians and staff should not only do an objective evaluation of the system and vendor, but also consider whether users have had realistic expectations and been truly committed to the EHR's success. Practices should ask themselves if a response time of a few hours for a routine issue is sufficient reason to switch vendors, or if it's an annoyance they can live with. On the other hand, if the support staff consistently takes four days to return calls, the practice may very well want to investigate other options.
Practices should also consider whether or not they've adequately invested in training resources, especially following the implementation of new features or a turnover in staff. A practice that resists spending money for ongoing education may be equally discontent with its next EHR.
Specific Considerations
Before switching EHRs, users should take the time to verify whether or not particular issues can be fixed and/or if they can live with certain limitations. For example:
- Challenging workflows -- Physicians often complain that their EHRs are slow -- or simply don't work. The problem, however, could be that a particular EHR is not designed or adaptable to a provider's specific workflow. For example, the workflow of a primary care provider seeing 30 patients per day is very different than that of a specialist treating fewer, more complicated patients, or one seeing a mix of follow-up patients and patients requiring in-office procedures. The EHR may include all the functionality the physician needs to thoroughly document a regular office visit, yet be inefficient for documenting procedures -- or vice versa. Depending on the EHR, the documentation process may require an inefficient number of steps and reduce the number of patients the doctor can see per day. Practices should ask their vendor if the EHR supports alternate workflows that are better suited to an individual provider's needs based on specialty and patient flow.
- Lack of system enhancements -- A practice may have implemented an EHR that worked great for several years, but now the vendor is failing to keep up with the latest regulatory requirements, or with new technologies that increase efficiencies or enhance revenues. This is the situation that many providers are facing as they scramble to address MACRA requirements. Other vendors may be addressing government-mandated changes, but not offering solutions to enable interoperability with other providers, or to facilitate participation in optional revenue-enhancing programs, such as CMS's Chronic Care Management (CCM) Services.
- Technology limitations -- Practices that use one software for practice management or billing and another for EHR often face a myriad of challenges. A practice must manage two vendors on a business level, plus coordinate timing for updates to minimize the risk of "breaking" things. Full integration between disparate financial and clinical systems is increasingly rare, making the "best of breed" approach a struggle for practices trying to address today's burdensome regulatory and reporting requirements.
- Support -- No matter how great a system is a practice is going to struggle if its vendor fails to address system issues in a timely manner. A practice must evaluate its vendor's ability to deliver consistent and reliable access to knowledgeable support professionals who can communicate clearly and provide appropriate instructions and advice.
Source: Health IT Outcomes (View full article)
Posted by Dan Corcoran on November 15, 2017 07:08 AM
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