ACC: Facilities are not yet ready to adopt EHRs for meaningful use
ATLANTA—As U.S. lawmakers push facilities to adopt health IT technologies, problems often arise during the implementation process demonstrating that facilities may not be ready to make the switch toward meaningful use, said John Windle, MD, of the University of Nebraska Medical Center (UNMC) in Omaha, during his presentation at the American College of Cardiology (ACC) scientific sessions Sunday.
While there are tremendous pressures for the rapid implementation of EHRs, Windle said the 2011 deadline set forth by the Office of the National Coordinator for Health IT (ONC) may not be reached by some facilities as current EHRs often pose problems.
He highlighted how UNMC adopted a successful "home-grown" method to transition into EHR use and overhaul the problems associated with that transition.
“We recognize that structured electronic data will make it easier to measure quality and outcomes, which is why the motivation has been there, but we continue to see that records don’t connect at some levels,” said Windle.
He also said that problems can occur during the adoption of health IT technologies and these can hamper quality, workflow and patient care.
The use of an EHR can create errors within the coding and documentation process at a facility. These problems stem from ICD-9-CM codes that often cause information to be misconstrued. With the mandatory implementation of ICD-10-CM on the brink, transitioning into ICD-10 “is going to make things much worse” because of its added complexity.
To uproot the deficiencies within these IT solutions, Windle said that interoperability could be the "key to success."
In 1980, UNMC replaced its paper-based system with an EMR and later integrated to an inpatient and outpatient EMR that 450 physicians and 150 private physicians use.
For successful EHR adoption, he said a major factor is making sure that health IT solutions do not compromise patient care.
According to Windle, the average resident at UNMC spends 10 minutes prior to a procedure prepping the patient within the EHR and 10 minutes after the procedure performing documentation using the computer solution. In comparison, the resident spends an average of four minutes providing hands-on patient care in a patient's hospital room. He said that facilities must work to repair the lack of human interaction that may occur with EHR use.
During the EHR adoption process at UNMC, physicians created a customized platform that included problem lists, a computerized provider order entry (CPOE) system and a computer decision support (CDS) system.
Windle describes the CDS as the “holy grail of informatics and EHR use." According to Windle, deploying decision support systems was estimated to save UNMC an average of $70 billion per year.
Windle said the following aspects help facilities gain meaningful EHR use:
While there are tremendous pressures for the rapid implementation of EHRs, Windle said the 2011 deadline set forth by the Office of the National Coordinator for Health IT (ONC) may not be reached by some facilities as current EHRs often pose problems.
He highlighted how UNMC adopted a successful "home-grown" method to transition into EHR use and overhaul the problems associated with that transition.
“We recognize that structured electronic data will make it easier to measure quality and outcomes, which is why the motivation has been there, but we continue to see that records don’t connect at some levels,” said Windle.
He also said that problems can occur during the adoption of health IT technologies and these can hamper quality, workflow and patient care.
The use of an EHR can create errors within the coding and documentation process at a facility. These problems stem from ICD-9-CM codes that often cause information to be misconstrued. With the mandatory implementation of ICD-10-CM on the brink, transitioning into ICD-10 “is going to make things much worse” because of its added complexity.
To uproot the deficiencies within these IT solutions, Windle said that interoperability could be the "key to success."
In 1980, UNMC replaced its paper-based system with an EMR and later integrated to an inpatient and outpatient EMR that 450 physicians and 150 private physicians use.
For successful EHR adoption, he said a major factor is making sure that health IT solutions do not compromise patient care.
According to Windle, the average resident at UNMC spends 10 minutes prior to a procedure prepping the patient within the EHR and 10 minutes after the procedure performing documentation using the computer solution. In comparison, the resident spends an average of four minutes providing hands-on patient care in a patient's hospital room. He said that facilities must work to repair the lack of human interaction that may occur with EHR use.
During the EHR adoption process at UNMC, physicians created a customized platform that included problem lists, a computerized provider order entry (CPOE) system and a computer decision support (CDS) system.
Windle describes the CDS as the “holy grail of informatics and EHR use." According to Windle, deploying decision support systems was estimated to save UNMC an average of $70 billion per year.
Windle said the following aspects help facilities gain meaningful EHR use:
- Integrating the EHR into the current system solution helping to create a seamless workflow;
- Being clinically relevant by providing the right information, in the right context through EHR to aid in reducing documentation errors;
- Being available at the point-of-care;
- Supporting real-time problem lists; and
- Providing decision support.