By Julie Fouque, Director of Marketing
Lately I’ve been reading about two trends related to electronic medical record (EMRs) or electronic health record (EHRs) systems: interoperability and consolidation. As healthcare organizations across the country have completed the move from paper records to EHRs, EHR adoption is essentially complete. The conversation has shifted from EHR adoption to interoperability and, due to trends I’ll point out below, EHR consolidation.
I was shocked to learn a few statistics from Tom Sullivan at Healthcare IT News:
- The average hospital has 16 disparate EMR vendors in use at affiliated practices
- 75% of hospitals are dealing with 10+ disparate outpatient vendors
- Only 2% of hospitals have a single vendor in use at affiliated practices
What’s more, “the average health system…has 18 different EMR vendors when looking all the way across affiliated providers.”
Tom’s article goes on to say that “while the number of vendors does reflect specialty EMRs that won’t replace core vendors, the sheer number of systems points to an obvious interoperability nightmare. It’s not just the reality that implementing, running and maintaining all the different products have created something of a mess, either. Healthcare as an industry needs interoperability to be able [to] move forward now that the system is digital.”
This is an understatement for sure.
The second aspect of EHRs is about consolidation. In the digitized medical universe, healthcare organizations are getting smart and consolidating their core EHR systems, which can be seen by two market drivers: mergers and acquisitions and market saturation by EHR vendors.
Mergers and acquisitions have dominated the healthcare landscape over the past few years. With mergers and acquisitions comes overlap or redundancy in EHRs. From both practical and business perspectives, hospitals and healthcare networks don’t want to have data on multiple EHRs. This creates data silos, makes it harder for clinicians and health information management (HIM) staff to get information, and drives up licensing, maintenance, and support costs.
The number of EHR software vendors is also changing. A 2017 article by Clinician Today cited the availability of more than 1,100 EHR systems on the market. Today, however, predictions are that the EHR landscape will likely shrink. As Health Leaders points out, “The widespread adoption of electronic health records by payers and providers in recent years means fewer customers for software vendors, and that could lead to significant consolidation within the EHR sector.”
Managing the EHR Mess
One conclusion to be drawn from EHR consolidation is that it’s fueling efforts by hospitals and healthcare networks to consolidate on primary enterprise EHRs, such as Epic, Cerner, Allscripts, GE Healthcare and other leading systems.
This matters to Flatirons Digital Innovations and our clients. IT departments and risk management leaders have their hands full minding data on the core and specialty EHRs while simultaneously tackling interoperability issues. They cannot afford to create usability issues related to legacy systems or introduce related data management risks.
Fixed One Problem, Created Another
In the effort to consolidate onto one core enterprise EHR, other problems are created. Typically, when EHR data is moved from a legacy system to the core EHR, only the most recent data is moved to the production system; the rest stays on the original EHR.
So, while these organizations have reduced the number of core EHRs being used, other challenges have arisen.
- A clinician reviewing a patient’s medical history to make a diagnosis must access multiple EHRs to get all the information to inform their diagnosis. EHR fatigue with one system already slows clinicians down. Requiring them to use multiple systems only makes it worse.
- A HIM specialist responding to a HIPAA-required request of information must consult two systems and the chance to introduce errors increases.
- Another HIM specialist responding to a Recovery Audit Contract (RAC) audit must account for information on multiple EHRs, which introduces room for error.
- The accounting department is trying to stay on top of patient accounts, but some billing information is on the current system and other outstanding billing information resides on the legacy EHR. Accounting’s job has become more difficult.
- The IT department, pressured to support innovative solutions that promote customer-centric care, struggles to find budget because valuable dollars are still being pumped into fees to support legacy EHRs. What’s more, the risk of a data breach or data loss increases because security updates may no longer be supported on legacy systems.
Gain Control of Legacy EHR Data
Fortunately, addressing this challenge can be straight forward. Archiving clinical data allows healthcare organizations to move information from legacy EHRs to a secure, consolidated, and compliant archive and eliminate legacy systems.
When healthcare organizations do, they:
- Give clinicians, HIM staff, and accounting easy access to all legacy EHR information through a link within their enterprise EHR.
- More easily meet compliance requirements for historical information.
- Reduce the risk of failed audits.
- Free IT budget for strategic initiatives.