- Innovative EHR use can solve a host of healthcare’s biggest problems, according to a new op-ed in Harvard Business Review.
Virginia Mason’s James Bender, MD, and Robert S. Mecklenburg, MD, highlighted how innovative EHR use presents new opportunities to reduce excessive spending, medical errors, and unnecessary surgeries.
“Every day, online retailers use computer-based transactions to guide us through stepwise sequences to buy a pair of jeans, apply for a credit card, or book a flight. As we follow these electronic pathways, we can’t really go wrong: If we omit critical inputs or make an inappropriate choice, the program does not allow us to proceed until we get it just right,” wrote authors
“This same mistake-proofing process and technology embedded in the EHR can move us a great distance toward safer, higher quality, and more affordable health care,” they continued.
While Bender and Mecklenburg acknowledge EHR adoption has been a challenge for healthcare providers and organizations, they maintain there is “no question” users and patients benefit from improvements in patient safety, care delivery, and care accuracy.
In addition to improving safety by enabling accurate health data access, EHRs also ensure patient safety by eliminating the potential for human error in daily operations. Computerized physician orders eliminate the use of illegible provider handwriting and the potential for misinterpreted verbal orders. Meanwhile, features such as checkbox options offer providers only correct doses to prevent overdosing.
“When Virginia Mason Medical Center implemented computerized “order entry,” confusing or incorrect physician orders fell from 50% to near zero overnight,” wrote authors. “And at the bedside, nurses now compare a bar code on the patient’s wristband with the label affixed to medication to ensure the right patient receives the right medication.”
The introduction of the EHR system in healthcare has also ushered in a new era of innovation. Healthcare organizations and health IT developers are collaborating to further enhance existing features and develop new technologies.
“Long before innovations become commercially available, they are tested and refined as small-scale improvements programmed into an individual medical center’s EHR,” they stated.
EHR systems spread more information than just patient health data—the technology also brings evidence-based, best practice guidelines into clinician workflows for use at the point of care.
Health IT developers have also innovated ways to incorporate automation and artificial intelligence (AI) into care delivery.
“When blood thinners or insulin are ordered at Virginia Mason, an internally developed program automatically orders the essential lab tests necessary to safely adjust these medications.”
While EHR use has clear advantages, many providers and vendors are still hesitant to embrace changes.
Bender and Mecklenburg made three recommendations to assist health IT innovators and healthcare organizations in embracing the innovative potential of EHR technology. First, they wrote, organizations should set forth explicit, best practice standards to reduce variation in care management.
“Such standards have been implemented by groups where there is institutional alignment on quality,” stated authors.
Authors then recommended medical centers and health IT developers continue to collaborate to embed best practices protocols into EHR technology and assist physicians in clinical decision making.
“A priority should be the development of “hard stop” tools that can block unsafe or inappropriate care (e.g., the ordering of an unnecessary imaging test),” suggested authors. “These applications of the EMR are in early development.”
Finally, Bender and Mecklenburg stated purchases should require adherence to evidence-based standards in bundled-payment contracts.
“Adding predictable pricing, warranties against avoidable complications, and transparent reporting of market-relevant outcomes reinforces accountability for providers to improve quality and affordability,” they maintained.
These strategies could proliferate effective EHR use across the industry and help providers still skeptical of the technology’s efficiency to see real improvements in clinical processes.
“Providers that embrace the full functionality of the EMR will have an advantage in gaining market share and in lowering their costs,” authors said.