Digital Debut

Pick the Right EHR

Look for essential features that optimize workflow, enhance outcomes

BY TOM SCOTT | DECEMBER 2018

Over the past 10 years, electronic health record (EHR) adoption across all hospitals has increased from less than 10 percent to 96 percent, according to the Office of the National Coordinator for Health Information Technology. From information about the ASC industry that I have seen, I estimate that adoption in ASCs, however, has been low: less than 10 percent. A certain percent of hospital-owned/affiliated ASCs use hospital EHRs but that percentage, I expect, is still low because of the cost of the hospital EHR products and the incompatibility of feature/functions between a hospital-based system and a surgery center-based system.

Across settings, the adoption of EHR technology has not been without growing pains. EHRs are the technology that physicians love to hate, even as they become more reliant on them.

EHRs have gotten a bad name and a bad reputation among clinicians. They are supposed to improve health care by automating and streamlining processes and lead to improved patient outcomes. In too many cases, however, EHR implementation goes wrong, and clinicians find that the EHR impedes rather than enhances their daily work. This is one reason ASCs have been reluctant to adopt EHRs.

It doesn’t have to be that way, though. The right EHR solution, implemented in the right way, will help, rather than hinder, clinician workflow. The right solution will get the right clinical data to the right clinician at the right point of care, improving patient outcomes and reducing physician burnout.

The key is to look for EHR features that make sense in the context of ASC workflow. Due diligence in researching solutions up front can help ensure that your EHR implementation will end up earning praise, rather than insults, from your clinical staff.

These three key EHR features will help you get the results you want:

1. Flexible workflow. ASCs’ competitive advantage over other providers is based on operational efficiency. To maintain that advantage, ASCs must ensure that EHR deployment enhances, rather than obstructs, the clinical workflow. To that end, it is important that ASCs consider solutions designed specifically to accommodate ASC workflow.

Big, enterprise EHRs designed for inpatient organizations are not typically optimized for ambulatory outpatient facilities. Too often “one-size-fits-all” becomes “one-size-fits-nobody.” There is no quicker way to alienate a physician than to say, “You have to change your entire workflow because the EHR won’t allow us to do it that way.”

Your EHR should accommodate your organization’s unique workflow, not the other way around. To make sure that happens, look at solutions that are designed specifically for the ASC industry and that offer flexibility in charting. Solutions that feature a modular design will allow you to easily customize the charting system to your workflow without paying exorbitant fees to customize an inflexible off-the-shelf solution.

2. Customized views. In the old days, clinicians had to flip through pages and pages of a patient’s paper chart to find the information they were looking for. It was time-consuming for physicians to find the specific information they needed to review and sign off on.

Some of today’s EHR solutions are not much better. Instead of flipping through paper pages, clinicians are forced to click through screen after screen of digital information that is not relevant to them. The solution to this problem is a feature called customized views. Customized views allow an organization to attach specific data fields to particular clinician workflows. This means the preop nurse sees what a preop nurse needs to see; and the surgeon sees what the surgeon needs to see. Neither one has to click through a lot of irrelevant data to perform their specific tasks.

3. Concurrent charting. EHRs beat paper charts every time when it comes to data accessibility. No more pulling of patient charts from off-site storage facilities, no more searching for that one paper folder and trying to figure out who had it last.

Unfortunately, some EHR solutions restrict chart accessibility to one person at a time. You might not be looking for the last person who had the paper chart on their desk; instead, now you are looking for the person who last signed into the patient’s electronic chart, so you can get them to sign out and you can get the access you need.

The solution to this problem is a feature called concurrent charting. An EHR with concurrent charting enables multiple clinicians to review the same patient chart at the same time. A color-coding feature instantaneously lets users know what information has been updated, so everyone is working from a current version of the chart.

After all, the point of an EHR is not to simply replicate the old paper charting system, it is to improve workflow, not reproduce an inefficient workflow in a digital format. Ultimately, clinician satisfaction can have a big impact on the return on investment (ROI) of your EHR. That is why, when you are looking for an EHR for your ASC, it is a good idea to look for clinician-friendly features like flexible workflow, customized views and concurrent charting.

Tom Scott is the chief financial officer of HSTpathways, headquartered in Lafayette, California. Write him at tom.scott@hstpathways.com.