Florida in late May/early June might sound like a vacation, but it was a hot and humid week with storms ripping up the sky like clockwork each evening. That feels a bit emblematic the time period we have come through with regard to EHR’s. I’m sure many have felt the “heat”, “wind” and “rain” of the demands of Meaningful Use, etc. and I’m certainly not going to suggest that is all in the past. ICE is an IT services company focused specifically on serving community and rural healthcare organizations, so it’s no surprise that MEDITECH is a Healthcare Information System Software we find ourselves working with frequently. MEDITECH presently holds a 26% share of the US hospital EHR market and 40+% of the Canada hospital market. Most of that user base is squarely in the community hospital space. Given that market share, I think one can take some observations from this event and apply them generically to the community hospital experience and that’s what I intend to do here in three short points:
Independent community hospitals are still very much alive
In many cases, they are thriving in spite of what the large conglomerates and Epic would have you think. At last week’s conference, I met and observed a number of business professionals that have clearly moved beyond the “software implementation” and are now seeking new and innovative ways to drive value to their patients and their organization. There is very little support for “rip and replace” among this group and I see that as a positive sign for the industry.
Desired and Attainable Enterprise-wide EHR strategy
Adopting an enterprise-wide EHR strategy is a strong desire and is viewed as attainable among this target group. I would take it even one step further and say that this group believes it is MORE attainable in the independent community organization than it is in the larger health systems. A common record from ambulatory clinic, to ED, to Inpatient, OR, OB and even Homecare is a focal point as it should be. While we may always have to maintain strategies to integrate third parties into the mix, we can significantly enhance organizational performance, reporting and efficiency by consolidating within our own walls. MEDITECH has demonstrated a steady approach to attaining this goal for their customer base. They might not be the fastest or first to market, but they do methodically continue to provide new toolsets, which enable a more complete enterprise strategy. That speaks to why they are in the market share position I mentioned above. Community hospitals should be charting a path to an enterprise strategy and they can do so without giving up their independence. The application choices in the industry are fewer today, but they are getting better.
Clinician efficiency isn’t just a catch phrase or IT oxymoron
Clinician efficiency is a critical continuous improvement initiative. At the conference there was much talk about reducing clicks and making the functions and actions of the EHR applications more intuitive. The users at this conference were introduced to new web tools from MEDITECH who also related positive early results in that area, but IT leaders need to continue to take ownership of this push to clinical efficiency/effectiveness. There are numerous ways to improve the clinician experience and we must begin to focus on enhancing our entire IT approach to that end. Certainly, some of the answer is in pushing the envelope with the EHR vendors. Mobile apps at their core are more responsive to end user workflow, but we can’t leave it all at the feet of the app vendor. There are numerous ways to streamline the end user experience, from authentication strategies to password management to support and customer service, to enhanced reliability and availability of systems. One observation hit me while listening in to some hospital IT staff members lamenting over lunch about the lack of commitment and adoption from their nursing and physician staff. My observation is this: the IT organization and clinical department leaders MUST begin to see their everyday life as a collaborative continuous improvement effort rather than a fight to co-exist in spite of each other. I hear hospitals say that they have embraced concepts like Lean frequently when I ask, but what I observe are cultures that are completely counter to the concepts of collaborative continuous improvement. Unless IT and the clinical leaders begin to truly embrace a team approach to solution identification and implementation, it will be a long road to success regardless of what the app vendors do.
I do believe we are moving toward a time where the big storm of EHR’s, Meaningful Use, etc. is past and the cleanup can begin and that’s usually a refreshing time. The sky seems a deeper shade of blue, the plants stand a little taller and a lot of dirt has washed away. It’s also an opportunity to plant something new, so, set your sites on the possibilities and see what grows!