The Unforeseen Cost of EHRs
Health and Human Services Secretary Sylvia Mathews Burwell just received a letter from Congress — and it was not a New Year’s greeting. The letter, signed by 30 congressional members, takes issue with the 2015 full-year reporting requirement for meaningful use and recommends instead a 90-day reporting period.
The letter notes, “Our constituents remain concerned that the pace and scope of change have outstripped the capacity of our nation’s hospitals and doctors to comply with program requirements.” The letter also points out that HHS has “disregarded recommendations made by the vast majority of health care stakeholders to allow a shortened reporting period in 2015.”
While politicians wrangle for a solution, hospitals and health networks must continue their race to meet meaningful use deadlines. In the rush, administrators and other stakeholders have little time to stop and fully assess the impact of their EHRs.
Taking a Step Back to Evaluate EHRs
According to an online study in the Journal of the American Medical Informatics Association, EHRs drive positive financial gains, but those gains come at a price. The study concluded that while revenues increased, productivity declined. The average loss in productivity was equivalent to 108 fewer patient visits per quarter. And this study is not the only one to identify productivity challenges when it comes to EHR use.
Following up on a questionnaire sent out by the American College of Physicians two years ago, a new study conducted by the Lister Hill National Center for Biomedical Communications, found that physicians lost, on average, four or more hours per week.
- 89 percent of respondents said at least one aspect of data management was slower after implementing an EHR.
- Nearly 64 percent said note writing took longer and more than 32 percent said reading other clinicians’ notes took longer.
- Fully one-third of respondents said it took more time to find and review medical record data with an EHR.
The majority of the study participants had their EHRs in place for more than a year, so the productivity loss cannot be attributed simply to the learning curve. Clement J. McDonald, MD, who led the Lister Hill study, wrote, “The loss of free time that our respondents reported was large and pervasive and could decrease access or increase costs of care.”
These concerns make it even more challenging to meet meaningful use deadlines.
Driving More Effective Use of Health IT
In addition to working towards meaningful use deadlines, hospitals and other health care providers need to find ways to adjust to the productivity losses by better addressing population health and improving patient engagement.
Jonathan Weiner, professor of Health Policy and Management at the Johns Hopkins Bloomberg School and director of the Center for Population Health Information Technology, and David Blumenthal MD, president of The Commonwealth Fund and the former National Coordinator for Health IT for the U.S. Department of Health and Human Services, co-authored an article published in Health Affairs based on a study of health IT’s impact on health care in coming years.
Their conclusion? Despite the reported productivity challenges, researchers believe “… that electronic health record systems and other digital tools are likely to curb the demand for physicians in the future.”
This is yet to be seen. What cannot be forgotten is that patients are part of the demand equation. Beyond health IT, hospitals and physicians must align their offerings with patients’ individual needs, and understand how to best influence their behavior. Gaining insights into the attitudes patients have towards health care, as well as their motivations and personal preferences regarding health and wellness, helps health care providers “consumerize” their organizations, improving their ability to reach and engage patients.
Consumer insights are critical for driving efficiencies in health care delivery. One powerful source of consumer insights is psychographic segmentation, which classifies patients by their personal values and personality types, allowing hospitals, physicians and other health care organizations to design more impactful patient engagement strategies. In addition to encouraging desired behaviors for better disease management, medication compliance and wellness, improved communications can help health care providers overcome productivity losses and meet meaningful use deadlines.