EHR Implementation

Use of electronic health records (EHRs) among physician offices has skyrocketed over the past five years. Today, most national studies indicate that somewhere between 70% and 80% of office-based physicians are now using an EHR. The same studies reveal that 10% to 20% are in the process of implementing an EHR and the remaining 9% or 10% have no plans to implement a system. Some of the non-adopters have indicated that their decision is tied to plans to retire in the next few years.

The highest rates of EHR adoption are among primary care physicians, such as family medicine and internal medicine practitioners, and in practices with four or more physicians.

Now that most physicians have adopted electronic records, we are seeing two trends emerge: EHR replacement and an increased demand for integrated health information exchange (HIE).

EHR Replacement

First, we will discuss EHR replacement. With hundreds of EHR products on the market to choose from, many physicians who adopted EHRs for the first time two to four years ago were overwhelmed by their options. Few had the time or expertise to evaluate each product’s ability to meet their practices’ long-term needs. Additionally, many EHR vendors made promises about functionality that were only partially true, and others were overwhelmed by changing Meaningful Use requirements and were unable to certify their systems to the required 2014 standards. As a result, some physician practices are now finding that the EHR they purchased two, three, four, or more years ago can no longer meet their needs.

This, of course, is unfortunate in many ways including the fact that physicians invested significant amounts of resources (time and money) implementing their first EHR. However, if we set that aside for a moment and focus on the future, we know that Medicare payments and value-based care programs are either directly or indirectly tied to measures that favor physicians using EHRs, we know that many physicians in this position will need to move forward with a different EHR.

At CORHIO we have been helping physician practices select and adopt EHRs for five years now. We have built upon our initial in-depth research on available EHR products by working hands-on with practices as they go through implementations, attest to Meaningful Use, and connect to an HIE for seamless data exchange. We have seen first-hand which EHR products physicians have an easier time using, which products provide the best Meaningful Use reporting, and which have proven they can exchange meaningful data with an HIE.

If you or your practice is considering an EHR replacement, we invite you to contact us for information that could be helpful to your purchase and implementation decisions. We also provide guidance on EHR contracting to avoid surprising add-on fees that are not always proactively disclosed to physicians ahead of time. Additionally, on this site we maintain a list of EHR products that have demonstrated ability to connect to the CORHIO HIE.

Implementing an EHR with Data Exchange Capabilities

Many EHR products on the market today are interoperable – or capable of exchanging data in a way that supports physician workflow and patient care. However, no two EHRs exchange data in exactly the same way, and this is important for physician practices to know before they purchase or switch to a new EHR.

Some EHRs can receive data from other systems, such as another EHR or an HIE, but the data might be incorporated in a part of a patient’s record that is not intuitive for the user to find. Some EHRs require advanced customization of settings to receive information in a way that the physicians or users find helpful, which can be expensive. EHRs may proclaim to create, send, and receive patient care summaries in the form of continuity of care documents (CCDs), though in some cases the data is stored in a PDF-like fashion that is not easily used by another EHR and may be no more helpful than sending or receiving a paper record through fax machine. These limitations are rarely discussed by sales reps during the purchase process, so we advise physician practices to do their homework, or to get help from experienced IT professionals.

It is important to point out that some EHRs are highly capable and exchange data wonderfully with other systems, though it can be hard to identify these easily during the purchase process. And a system’s price tag may not be the best indicator of exchange capabilities.

We invite physician practices to contact us with questions about EHR products’ data exchange capabilities. We provide free over-the-phone advice on this topic for providers based in Colorado. Once you’ve implemented an EHR, we can also discuss the process to connect to the CORHIO HIE network.