Perspectives

Implementing and optimizing a modernized EHR

The meaningful use of electronic health records

The meaningful use of electronic health records (EHRs) can help improve the quality of care, patient safety, and clinical outcomes through care collaboration and evidence-based practice. EHRs can also help to reduce administrative paperwork and streamline workflow. Explore our latest thinking and research findings to help support effective EHR implementation and optimization.

EHR implementation missed the mark? How to hit the bullseye with optimization projects

The EHR is up and running, but the promised benefits are falling short of expectation. While many implementations start with the noble goal of transformation, health care organizations might actually find themselves building an EHR that mimics paper order sets, performs redundant documentation in the patient chart, and is based on a more generic vendor model. The approach may have its merits—namely acceptance by key clinicians and speed to go-live to meet regulatory timelines. Organizations usually plan for transformative workflow and content design during an optimization phase post-live. However, the effort and resources often feel depleted and efforts are often focused on bringing up other facilities within the system.

To actually realize the intended benefits of the EHR, organizations should quickly transition from less efficient workflows and content to those that are clinician supportive and transformational. It is this entry point that organizations can use an enhanced EHR, with transformative process change, to drive behavior change in users. Effective governance is at the heart of this change.

Once an organization establishes an effective governance program, the user community should begin to see their priorities and requirements addressed and understand when they are not. This will likely underscore and result in a need to transform organizational behaviors.

Successful organizations recognize that transitioning from system implementation to optimization is a competitive imperative. However, that transition requires a paradigm shift. To be successful, the organization should not use the same process used for implementation. Consider changing behaviors to:

  1. Support ongoing optimization for truly transforming care delivered to patients and
  2. Support physicians/clinicians in their complex and integrated processes delivering that care

Download the report to get started on critical steps to achieve EHR optimization.

Findings on health information technology and electronic health records from the 2016 Survey of US Physicians

Evaluating the sharing of EHR instances across organizations

A number of drivers–including the ACA, M&A activity, and MACRA–have spurred significant investment in the implementation of EHRs over the past decade. Large and complex health care provider organizations have led the way with these implementations, often making significant financial and other resource investments over an extended period of time.

Smaller and mid-tier community hospitals are now exploring options to either initially implement or modernize an existing EHR platform. Many are resource constrained and therefore seeking creative and cost-effective implementation models.

As technology costs continue to rise, identifying opportunities to increase the value of any technology investments across the health care landscape is critical. One way for such organizations to accomplish their goals within an abbreviated timeline and with reduced financial burden is to join an existing EHR instance owned and operated by another organization. Sharing instances can provide significant value to small and large organizations and increase the potential opportunities for value-based care delivery in those communities.

Embracing an existing EHR platform that is working well in another organization allows for rapid co-opting of leading practice clinical content, such as order sets, documentation templates, and decision support. It also provides demonstrably successful organizational workflows and the consolidation of shared technical services. The appeal of adopting another organization’s instance also includes potential enhancement of interoperability and improved clinical outcomes due to improved coordination of care and population health management. In many markets, sharing an EHR instance between a community hospital and a larger facility may result in improved patient satisfaction as access and coordination of care are improved. For clinicians, the shared platform promotes seamless access to patient information and facilitates communication between care providers.

While benefits exist, sharing an EHR instance also poses organizational and cultural challenges. Before making a commitment to a shared instance, both entities need to critically evaluate multiple dimensions of any proposed arrangement to maximize potential for proper fit for their organizations. Both organizations will need to address financial, operational, technical, and regulatory considerations. Establishing the right implementation strategy for a shared instance approach is critical. Download the full report to explore opportunities for cross-organizational connectivity and interoperability.

Shatter the mold. With Evergreen.

​Deloitte's Evergreen solution provides the resources, secure infrastructure for remote access, tools, methods, and processes to securely maintain and optimize your EHR through a seamless global delivery network. By leveraging various tools and techniques, we create an accelerated, cost efficient EHR implementation and support Application Management Systems (AMS) model.

By doing so, we help to configure and maintain the EHR content in a way that helps clinicians and executives make decisions, anticipate changes, predict outcomes, and manage populations (ACOs). Deloitte's Evergreen solution provides between 20 to 40 percent savings to clients compared to the traditional support models.

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