DALLAS, TX, March 6, 2020 – In the wake of the HIMSS conference cancellation, we take time that would have been spent getting sore feet to instead reflect on our view of the state of the Electronic Health Record (EHR).
The EHR era is evolving into a post-EHR deployment phase, what might properly be called What To Do Next With My EHR. Where and how have health systems realized appreciable financial returns? And are there new avenues by which to extract value from their biggest investment?
Before we explore new avenues, it’s worth asking, have health systems recouped a reasonable return on the enormous investment required to implement an EHR? EHR spend ranges from between $46,000 to $90,000 per provider in the first year alone when considering the additional costs of implementation, training, and supporting technology. That investment also does not include the revenue lost during the initial go-live, when providers are typically lightly scheduled for learning curve purposes. Some of this investment has been offset by nearly $30B in Federal funds contained in the 2009 HITECH Act for ONCHIT-certified EHRs deployed. But…we are now seeing health systems with buyers’ remorse, who bought EHR Vendor A – defrayed by Federal subsidies – now ponying up Brobdingnagian funds to deploy Vendor B. With no Federal reimbursement.
What gives? How can health systems recoup that investment?
When asked, health system leaders, vendors and consultants alike hem and haw and look at their feet. The best answer offered is ‘cost savings’ in the form of administrative efficiencies.
How likely is it that a 1,000-provider system that spent ~$200 million will actually recoup that expense? For that system to generate a 30% return – $260M in savings over 5 years – means recouping $52M a year – the equivalent of slashing 500 FTEs.
Don’t look for this kind of quantum-leap, AI-like technology breakthrough, since several leading EHRs are built on MUMPS, a 50-year-old technology.
However, there is another avenue of return from your EHR, which has made a timely appearance, in an era of increased competition. Provider consolidation, and business models which involve either payors aligning with providers, providers aligning with employers, and providers assuming greater risk and becoming payors, means that keeping patients in-network via customer intimacy – digital intimacy – is needed.
The stage is set, and the timing is essential, for turning your EHR into a top-line growth, revenue generating machine. How?
In a phrase, bring the EHR into the digital world. Extend your EHR to meet the expectations of your consumers. Expose provider schedules to patients hungry for mobile, on-line, on-demand scheduling. Give them the ability to find their provider – that’s qualified, has good reviews, takes their health plan, is convenient, and has availability, and let them self-schedule.
Only the EHR platforms – and third-party software scheduling vendors – can satisfy the availability part.
Job one is for CIOs to begin the necessary dialogue with physician leaders in both primary care and specialties about the need for open scheduling. Start it now…our experience working with health systems is it’s a worthwhile but challenging discussion. But the market is demanding it, and you’re a key steward – along with your marketing peers – to merge market demand and technology capabilities in a single dialogue to drive this transformation through.
One of our health system clients went through this gauntlet…now, nearly all of its provider schedules are open. In less than a year, 6% of its scheduling is now done online directly by patients. They’ve diverted tens of thousands of calls a month from their call centers. Savings are running over $5 million a year. It was sometimes painful, but necessary. And they aren’t looking backward. Providers are happier because they are busier. Concerns over payor mix have proven unfounded.
The next chapter in the story of meeting consumer demand for on-line scheduling is about better provider data.
Provider data is not the province of EHRs – they are purpose-built patient data platforms.
Provider data requires a purpose-built provider data platform. This is where Phynd comes in. We’ll talk more about this in a future installment.