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Electronic Health Record (EHR) systems were designed with the intention of streamlining medical processes. The efficiency they promised has been a point of debate for many in the healthcare sector. A recent KLAS report, conducted by interviews with 67 healthcare organizations, provides a an insight on this ongoing issue in the healthcare industry.
The Significance and Issue of EHR Efficiency
EHR’s effectiveness remains a key concern in the clinician experience, as shown by LAS Arch Collaborative research. Despite its potential, there is a gap in its performance: only 46% of clinicians feel their EHR system enhances efficiency. As well as this, there is a clear direct correlation between the lack of EHR efficiency and clinician burnout. Consequently, many healthcare institutions are seeking external help to boost EHR efficiency and improve the user experience.
Key Offerings to Enhance EHR Efficiency
The KLAS report identifies six primary offerings designed to improve EHR efficiency:
Clinical Transformation Strategy: This includes formulating strategies for clinician efficiency, spearheading informatics program development, and initiating delivery-model alterations.
Technical Build Assistance: Creating EHR systems and third-party applications.
Virtual Scribes: Services focused on optimizing clinical documentation.
Workflow Assessment and Refinement Services: Offering staff for customization initiatives, refining existing processes, and making documentation enhancements via efficiency data insights.
Vendor Selection: Assisting in the EHR selection process, evaluating EHR modules, and pinpointing efficiency-driven add-ons.
Interoperability Optimization: Aiming to make externally-sourced patient data more actionable for clinicians.
The report also singles out three software enhancements to augment EHR efficiency:
Documentation Burden Reduction: Aims at data aggregation and visualization in the EHR, supplemented by features like ambient voice and real-time speech recognition.
Message/Task Management (Inbox): A review and restructuring of message flows to correct inefficiencies.
Team Communication and Coordination: Enhancing team communication and automating a series of tasks.
Spotlight on EHR Vendors
EHR vendors such as athenahealth, Epic, MEDITECH, and NextGen Healthcare are noted in the report for their contributions:
Athenahealth is distinguished for its extensive service offerings and software solutions, ranging from strategy development to care team communication.
Epic is credited for its focus on strategy, application enhancement, and workflow design, among other areas.
MEDITECH stands out for its service offerings that span from strategy formulation to efficiency data analysis.
NextGen Healthcare, while spotlighted for a narrower range of services, is acknowledged for software solutions emphasizing data visualization and task coordination.
Gathering Feedback via KLAS Interviews
KLAS conducts numerous interviews with healthcare professionals annually, aiming to understand their perspectives on IT solutions. For this specific report, vendors were prompted to identify deep adopters of their clinician efficiency offerings. These adopters were then interviewed by KLAS to validate the offerings and extract insights about their respective experiences.
A Closer Look at the KLAS Arch Collaborative
The Arch Collaborative is a conglomerate of healthcare organizations with a shared vision: to improve the EHR experience. This is achieved through standardized surveys and benchmarking exercises. With participation from almost 300 healthcare organizations and feedback accumulated from over 440,000 clinicians, the Arch Collaborative’s mission is to transform patient care by maximizing the EHR’s capabilities.
In response to persistent resistance from the healthcare industry, the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) have announced an extension of proposed restrictions on the virtual prescription of controlled substances until the end of 2024. This extension grants healthcare providers the flexibility to prescribe controlled medications through telehealth for new patients without prior in-person examinations. This is the second extension provided by these agencies, the first of which was originally set to conclude in November.
The decision to extend these flexibilities comes after encountering strong opposition from healthcare organizations, trade associations, telehealth service providers, and various stakeholders. The DEA had initially planned to limit the scope of virtual prescriptions of controlled substances following the conclusion of the public health emergency (PHE) declaration prompted by the COVID-19 pandemic. During this period, the DEA temporarily relaxed the requirement for in-person examinations before telehealth prescribing of controlled substances, streamlining the process and ensuring continued access to necessary medications.
The DEA introduced a proposal to permanently extend certain pandemic-era telehealth rules related to virtual prescribing while ending others in February 2023. The proposal aimed to permit remote prescription of a 30-day supply of Schedule III-V non-narcotic controlled medications and a 30-day supply of buprenorphine for treating opioid use disorder (OUD) only if a prior in-person examination had taken place. Schedule II controlled substances like Adderall, Oxycodone, Vicodin, and Ritalin were excluded from this flexibility.
The DEA’s proposal received significant feedback, with numerous organizations expressing concerns. The American Hospital Association, for instance, argued that these proposed rules would introduce burdensome restrictions and additional administrative requirements for providers and patients, potentially hindering patient access to essential treatment.
In response to the feedback and concerns, the DEA extended the virtual prescribing flexibilities through November and held listening sessions in the preceding month. During these sessions, stakeholders from across the healthcare industry urged the DEA to permanently allow the virtual prescription of controlled substances without requiring prior in-person examinations. Healthcare providers emphasized the importance of this flexibility in enabling patients to receive essential care conveniently through telemedicine.
Healthcare stakeholders suggested the establishment of a telemedicine special registration process to ensure that virtual prescriptions without prior in-person examinations do not compromise patient safety. Such a process would enable practitioners to affirm their adherence to patient safety protocols and have plans in place for in-person assessments when necessary.
Telehealth advocates have welcomed the recent extension, recognizing its significance for patients and clinicians. This extension, now valid until 2024, implies that the coming year is poised to be a pivotal one for telehealth, with multiple other pandemic-era telehealth flexibilities also extended until the end of 2024. These include eliminating geographic restrictions on originating sites for telehealth services and maintaining coverage of audio-only telehealth services under the Medicare program. The DEA and HHS’s decision to extend virtual prescription flexibilities until the end of 2024 reflects their responsiveness to the concerns raised by healthcare stakeholders. This extension acknowledges the importance of telemedicine in delivering healthcare services and aims to strike a balance between accessibility and safety in the prescription of controlled substances through virtual means. The ongoing evaluation and development of regulations in this area demonstrate a commitment to the evolving landscape of healthcare delivery.
The release of the Zio® monitor by iRhythm Technologies, Inc. illustrates a progression in the field of cardiac health technology. With a 99% approval rating from physicians, it is clear that this innovation is meeting the high demand for enhanced accuracy and efficiency in diagnosing and monitoring cardiac health. The monitor is a more compact design than currently available, with enhanced with features prioritizing patient comfort and usability, positions this monitor as a pivotal tool in modern healthcare. It has been designed with an emphasis on both the user experience and the practical utility for healthcare providers. The monitor is noted for its lightweight and compact design, aimed at offering a less intrusive experience for the wearer. The device can be worn for up to 14 days without the need for battery replacement or adjustments, aiming to provide consistent data collection over an extended period, which is a basic requirement in cardiac health monitoring.
In the context of data collection and analysis, the Zio® monitor incorporates the ZEUS (Zio ECG Utilization Software) System. This AI algorithm is tasked with the capture and analysis of ECG data, part of the broader long-term continuous monitoring (LTCM) service offered by iRhythm. The end-of-wear report, generated after analysis and reviewed by certified technicians, is intended to provide healthcare providers with actionable insights. It should be noted, however, that while AI is employed in the data analysis process, the reliance on human technicians shows the importance of human expertise in validating machine-generated data.
Complementing the Zio® monitor is the MyZio® patient app. This redesigned application is positioned as an interface for patients, offering features for symptom logging and access to educational content. The role of technology in patient engagement is significant; however, it’s balanced with the need to ensure that technology remains a tool, not a replacement for human interaction and personalized care. The app is a nod towards the increasing trend of patient-centric care, where individuals are more actively involved in their healthcare processes.
The CAMELOT study referenced in association with the Zio® monitor indicates a high diagnostic yield and low retesting rates. While these findings are noteworthy, it’s essential to contextualize them within the broader landscape of medical technology, where continuous advancements and innovations are the norms. Cardiac arrhythmias, a concern for a substantial segment of the U.S. population, require precise and reliable monitoring tools for effective management. The Zio® monitor’s contribution to this field is marked, yet it is one of many tools and technologies that together shape the landscape of modern cardiac care.
Looking ahead to the broader availability of the Zio® monitor in U.S. clinics by 2024, the integration of technology into healthcare continues to be a focal point of discussion and development. The device and its associated services are components of a dynamic ecosystem where technology, healthcare providers, and patients intersect. While the monitor offers specific functionalities aimed at enhancing the precision of cardiac care, the evolving of medical technology necessitates ongoing assessment and adaptation to ensure that innovations align with the multi-dimensional needs of contemporary healthcare.
Recent insights from Kaufman Hall’s August 2023 report indicate signa of financial recovery within the hospital sector. A shift in the median year-to-date operating margin index from 0.9 percent in July to 1.1 percent in August unveils a positive trajectory towards financial resilience. In the wake of the severe economic impacts of the pandemic, such improvement is not only a relief but indicative of the robustness of strategic financial adaptations implemented in various hospitals. The improvement in both inpatient (4 percent) and outpatient revenue (12 percent) signals a broader fiscal recovery, enhancing the optimism surrounding the hospitals’ economic outlook. Hospitals are steadily emerging from the financial nightmare created by the pandemic, marked by unprecedented pressure on resources and fiscal reserves.
Despite the promising figures, warnings from the American Hospital Association (AHA) and financial analysts illustrate the need for caution. Operating margins, although showing an uptrend, are still below the comfortable thresholds that marked pre-pandemic levels. Ben Finder of the AHA, alongside other experts, stress that the narrative of fiscal recovery is intricate. A single-dimensional view, focused solely on positive financial indicators, can obscure ongoing financial challenges. The need for a comprehensive, multi-faceted assessment of financial health is important in drawing realistic and pragmatic fiscal trajectories for hospitals.
The call for a more nuanced approach to interpreting financial data stems from the historical and ongoing economic pressures detailed in reports by Fitch, Moody’s, and S&P. These agencies shows the story of 2022 marked by a significant decline in nearly every metric assessing the financial health of hospitals and health systems. Operating margins shrank, and days cash on hand, a measure of financial resilience, saw a significant reduction, as well as more credit rating downgrades than upgrades. It becomes evident that while strides towards financial recovery are present, economic uncertainties and pressures remain. Hospital leaders and CFOs are, therefore, confronted with the task of balancing short-term financial gains with long-term fiscal sustainability.
Healthcare leaders, especially CFOs, are now thrust into a role whereby they must anticipate and preparing for future uncertainties. The integration of predictive analytics, data-driven decision-making, and agile operational frameworks are vital, and their focus extends to ensuring that hospitals are not just economically viable but are also operationally efficient, technologically advanced, and patient-centric. The current financial uptrend offers an opportune moment for healthcare institutions to reinvest in innovations, enhance operational efficiencies, and increase their financial reserves to mitigate future recessions.
Primary Care Joliet, a healthcare organization based in Illinois, has recently commenced an eClinicalWorks EHR implementation process. The primary objective of this initiative is to bring administrative workflows under one umbrella, thereby simplifying processes, reducing unnecessary expenses, and more importantly, enhancing the continuum of patient care outside of the hospital environment. As part of this sweeping reform, Primary Care Joliet is tapping into the key tools of eClinicalWorks’ EHR. These include the innovative healow Open Access, healow Pay, and the analytical powerhouse of the HEDIS Analytics tool.
Healow Open Access is a tool specifically designed to offer an integrated platform for patients to view and schedule their appointments online. This cutting-edge solution aims to minimize the chances of missed appointments and foster overall patient satisfaction by providing an accessible and user-friendly interface for appointment management. On the other hand, healow Pay is a game-changer in the payment process. It offers patients a hassle-free payment experience by allowing them to settle their bills without having to go through the laborious process of logging into a separate patient portal.
As healthcare continues to evolve in the era of data and digital technology, Primary Care Joliet is also taking strides in leveraging data analytics to enhance patient care. The organization plans to use the HEDIS Analytics tool to identify care gaps, engage with patients more effectively, and monitor treatment compliance. This tool is designed to generate invaluable insights that could drive improvements in patient health outcomes. With the help of HEDIS Analytics, Primary Care Joliet can evaluate treatment plans based on real-time data, thus enabling the delivery of personalized and effective care to patients. This data-driven approach to healthcare will not only lead to improved patient health outcomes but also foster a more proactive healthcare environment where potential health issues can be identified and addressed before they escalate.
Boosting Clinical and Administrative Efficiency through Upgraded Software
Meanwhile, Tennessee-based chronic pain management practice, Encore Health Group and Affiliates, has chosen to escalate their operations by upgrading to eClinicalWorks’ V12 software. This strategic move is aimed at enhancing both clinical and administrative efficiency. The eClinicalWorks V12 platform offers functionalities tailored to streamline clinical documentation by improving application performance and enhancing user-friendliness. These enhancements are especially critical for pain management treatments, which require meticulous and detailed documentation.
Following the EHR’s implementation, Encore Health Group and Affiliates have reported a threefold increase in transactions via healow Pay, highlighting the impressive operational efficiency and patient convenience offered by the upgraded technology. This provides patients with a variety of options for secure payments, thereby improving financial efficiency and enhancing patient satisfaction.
Value-Based Care with Cloud EHR
UniVida Medical Centers have also recently adopted eClinicalWorks Cloud EHR to support their value-based care goals. This decision aligns with their ten-year strategic plan, emphasizing the importance of preventative care in delivering personalized and optimal patient care. The eClinicalWorks’ EHR system brings multiple benefits to UniVida Medical Centers, such as access to external patient data through PRISMA, a health information search engine that consolidates records from diverse healthcare entities like specialists, hospitals, and primary care providers.
The eClinicalWorks’ EHR system also plays a crucial role in improving operational quality by standardizing workflows with HEDIS dashboards. It further incorporates beneficial programs like Chronic Care Management (CCM), Transition Care Management (TCM), and Remote Patient Monitoring (RPM) to ensure continuity of care and improved patient outcomes. The vendor’s ongoing support and dedicated resources exemplify its commitment to UniVida Medical Center’s value-based care journey, further affirming the growing significance of cloud-based solutions in today’s healthcare landscape.
