The growing importance of clinician EHR utilization, and practical strategies to support usage
Why utilization of EHRs is critical against the backdrop of a changing marketplace
With a continually evolving landscape affected by greater demand for behavioral health services, an increased need for cross-disciplinary collaboration, changes in the reimbursement model and increasing competition, clinician adoption of Electronic Health Records (EHRs) is more important than ever before.
Increased demand and limited supply. Demand for mental health services has reached an all-time high and continues to grow, while the supply of hospital beds dedicated to mental health patients has steadily declined. Meanwhile, use of prescription therapies has grown, while outpatient and inpatient services remains flat. Recent reforms in reimbursement policies are expanding reasons to receive mental health treatment. As a result of all of the above factors, behavioral health organizations must focus on strategies for improving productivity, including adoption of certified EHR technology.
Growing integration of behavioral health and primary care. As many as 80% of patients with behavioral health problems present in the ER and primary care clinics, requiring behavioral health and primary care practitioners to mutually participate in integrated care for whole person health1. At the heart of this collaboration is the ability to access behavioral health information on a national scale instead of at the practitioner level. But supporting whole person health requires behavioral health clinicians to actively leverage health information technology across platforms to better coordinate care with primary care physicians and leverage cross-functional insights.
Payment reform is changing reimbursements from quantity- to quality-based. The Fiscal Year 2015 Hospital Value-Based Purchasing (Hospital VBP) Program adjusts hospitals’ payments based on their performance on four domains that reflect hospital quality: Clinical Process of Care, Patient Experience of Care, Outcome, and Efficiency. With two critical factors in future reimbursements being outcomes and patient experience, behavioral health organizations have the opportunity to leverage the power of EHRs to positively contribute to organizations who are actively preparing for this future.
Competition for behavioral healthcare services is increasing with more private equity investments. Strong market demand for behavioral health services, underserved markets and increased reimbursement for services are contributing factors in a thriving market for private equity investment. Market trends and business model characteristics combine for strong growth prospects in this undeniably significant market, with estimated current industry spending of $147.4 billion for mental health treatment and $24.3 billion for substance abuse treatment services2.
Yet, physician satisfaction of existing EHR systems is low
Despite the importance of clinician EHR adoption, physicians are frustrated and dissatisfied by their EHR systems. Two recent surveys by Accenture and Epocrates captured the responses of 1,500 doctors on the topic of EHR satisfaction:
In the Accenture survey, nearly 3 in 5 (58%) respondents agreed that their EHR system was difficult to use, while 71% felt health IT meant less time with patients. And when compared with 2012 survey results, more doctors said EHRs are negative influences in the quality of their care, with 12% believing that EHRs increased errors3.
In the Epocrates survey, which focused on data-sharing, sixty percent of physicians gave vendors a failing grade on interoperability. And 62% said the lack of data-sharing was not because the EHR was incapable of it. More than 90% of those surveyed said the lack of interoperability led to redundant or delayed care4.
6 Practical Strategies for Improving EHR Utilization
By employing simple, yet effective strategies prior to implementation and beyond, you can help increase clinician adoption and satisfaction of your EHR, while improving patient outcomes and driving the success of your business. Use these 6 strategies during your system selection process and throughout the lifecycle of your system for maximum EHR utilization:
Involve the right level of clinical leadership in EHR system selection and management
Clinical leadership in behavioral healthcare organizations—including the Chief Medical Officer (CMO) and Chief Clinical Officer (CCO)—must be involved in the EHR selection, implementation and ongoing work effort. The CCO bridges the gap between clinical and administrative implementation considerations, and is responsible for either selecting clinical champions or acting as a champion. The CCO helps translate the administration’s vision for patient experience and clinical quality to clinicians while communicating clinicians’ desires and concerns to the EHR team.
Ensure software personalization and usability
Usability is a measure of how easy it is to perform prescribed tasks—from design, to information flow, to the user experience. A central attribute that determines a product’s acceptability is usefulness, which measures whether the actual uses of a product can achieve the goals the designers intended. An upgrade from user acceptance testing to usability testing can provide deeper insights into system usability and therefore adoption. Adding the ability for role-based personalization drives content optimizations and supports a productive user experience.
Deploy a multi-layered strategy to support training, troubleshooting and questions
Transitioning from one EHR to another, or from paper to EHR is a challenging process for staff as their short-term workload increases significantly. When questions and issues arise, having multiple support systems to address clinicians’ needs is essential. Research shows that peer-to-peer training is more effective than vendor training, and underscores the importance of having on-site experts or super users who can provide fast resolution to questions and issues. Establishing mentoring relationships between early and late adopters can also improve adoption.
Employ smart devices for more efficient clinician-to-patient communication and enhanced care
Healthcare users want anytime, anywhere access to data and systems. True browser-based, browser agnostic applications like laptops and tablets can improve usability and enhance patient care. Point-of-care data capture and decision support improves clinician productivity, system utilization and patient care. Use of smart devices can shift the burden of data collection from the healthcare professional to the patient by automating registration intake information, vitals and health data tracking and reporting.
Underscore the value of evidence-based content
Using evidence-based content throughout the EHR improves the ability to diagnose diseases and reduces—even prevents—medical errors, improving patient outcomes. Additional benefits associated with EHR use include faster adoption of clinical evidence as well as improved risk management, patient safety, public health outcomes, patient satisfaction and document coding.
Improve collaborative care through single-system access
With the increasing focus on providing whole person care, greater collaboration across medical disciplines is needed, but is not always easy. A single, integrated EHR for behavioral health and primary care improves user adoption by eliminating the need for clinicians to access multiple systems to find patient health information. The ability to seamlessly integrate solutions from other vendors within the EHR through single sign-on creates a streamlined user experience that increases overall satisfaction.
Talk with Core Solutions today to learn more about out-of-the-box functionality that meets the unique needs of your behavioral health organization while supporting utilization among your clinicians.
About Core Solutions
Core Solutions, Inc. (Core) is a progressive leader in providing Electronic Health Records software to the health and human services industry. Core is a mission driven organization with the goal of improving the lives of individuals and families receiving behavioral health services through better technology. Our strategy for achieving this mission is through a “Better EHR Experience.” Talk with Core Solutions today to learn more about out-of-the-box functionality that meets the unique needs of your behavioral health organization while supporting adoption among your clinicians. Learn more at www.coresolutionsinc.com.
- R. G. Kathol, S. Melek, and S. Sargent, “Mental Health and Substance Use Disorder Services and Professionals as a Core Part of Health in Clinically Integrated Networks.” In Clinical Integration: Accountable Care & Population Health, third edition, eds. K. Yale, J. Bohn, C. Konschak et al. (Virginia Beach, Va.: Convurgent Publishing, forthcoming).
- Levit, Federal Spending on Behavioral Health.
- Accenture Doctor’s Survey 2015 US Report.
- Epocrates Interoperation Research Study, April 2015.