Return on Investment in the Face of Enterprise Change: Infirmary Health's Journey to EHR Optimization

Feb. 6, 2017
In the full article, we learn how Infirmary Health optimized the EHR for physician adoption and how that was key to the larger cultural change required for moving them from a traditional hospital-centric environment to the patient-centered, accountable care, and population health model of the future.

Pundits may call this the “Post-Electronic Health Record (EHR) Era”, but a more accurate—albeit clumsy—title may be the Post-Meaningful Use-EHR Implementation Era. From a simplified perspective: having invested millions of dollars in these systems, hospitals and health systems are focused today on extracting value from EHRs even as the technology and business models that spawned them change.

  1. Change has never been more of a factor in an industry that has never stopped changing. The convergence of cloud computing, mobile devices and consumerism with value-based, accountable care and population health—all of that in an industry consolidating so rapidly that half the number of health systems in existence today may be gone in the next five to 10 years.
  2.  In considering these factors, delivering upon investment has become the rallying cry of the era. In a recent PwC research report outlining expected 2016 trends in healthcare, 2016 is dubbed the year of “merger mania”—muddying and complicating what is already a difficult mission of delivering on the investment of the EHR.
  3. Add the massive cost of the EHR, and return-on-investment becomes even more critical for provider leadership. In a 2011 study commissioned by the Agency for Healthcare Research and Quality (AHRQ), it is estimated that the cost of implementing an EHR system in a physician practice was $32,409 per physician through the first 60 days after system launch, with an estimated cost of $17,100 per physician annually. Similar results were reported by community-wide initiatives and systems studied in Massachusetts and New York City.
  4. Pair this with recent data released by the Medical Group Management Association (MGMA) that reported a 71 percent increase in health information technology (IT) costs over the past few years, and it is clear why driving adoption and return on investment for the EHR is an imperative for the modern Chief Information Officer (CIO).

Still, forward-thinking healthcare CEOs call this the most exciting time of their lives due to the new opportunities for innovation in an IT-enabled, patient-centered environment focused on health and wellness. Healthcare CIOs see opportunity in innovative strategies to optimize the EHR so clinicians will adopt it and generate the value it always promised: becoming the digital engine of the Triple Aim. Hospitals and health systems aren’t focused on a post-EHR era, but on an EHR-optimization era.

“EHR optimization can be defined as improving three aspects of the EHR experience,” says Luis Saldana, MD, MBA, chief medical informatics officer at Arlington, Texas-based Texas Health Resources. “Those aspects are effectiveness, efficiency and user experience. Back in 2005, the EHR tools were rudimentary. The intent was to get our users to adapt to significantly new workflows and tools. It was quite difficult for physicians and they did it on faith. Since then, we’ve tried to address the EHR’s shortcomings and change them from being a tool that you have to adapt, to one that helps you deliver care.”

Healthcare CIOs see opportunity in innovative strategies to optimize the EHR so clinicians will adopt it and generate the value it always promised: becoming the digital engine of the Triple Aim.

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