Build multiple levels of value into an EMR to produce ROI

Want a return on the sizable investment in an EMR? View the technology not as merely a replacement for paper charts, but as the basis for creating new capabilities within the organization, such as information exchange, care coordination, accountability for patient outcomes and higher reimbursements.

That's the advice that Daniel J. Marino, president and CEO of Chicago-based consulting firm Health Directions, dispenses in a commentary for Hospitals & Health Networks magazine.

"[T]he total cost of rolling out an electronic medical record (EMR) outweighs any direct savings from improved information management. Many hospital leaders figure the cost is simply the price of keeping up with technology," Marino writes."The only way to avoid chronic losses is to enhance the value of the physician EMR. The key is to create new processes, new connections and new management skills that amplify the clinical, financial and strategic utility of the core EMR system."

Marino expresses the widely held belief that hospitals need to establish implementation teams to aid clinicians and staff in redefining workflows. "Because implementing an EMR is such a big change for a practice, the more training, education and hands-on support physicians and staff receive, the more they will be able to use the system to improve performance outcomes," he says. "The same principle applies to eligibility verification, charge capture, coding, compliance-related reporting and many other functions. Only by thoroughly integrating workflows with EMR capabilities can the organization realize the full value of an EMR system."

Interoperability is another way to unlock the value of an EMR, but because it's impossible without basic EMR functions, many organizations foolishly see it is an issue for later stages of planning. Marino says hospitals must start thinking about interoperability from the onset of an EMR implementation so that the standards, infrastructure and data-sharing model are in place when it comes time to move data outside the walls of the organization.

Marino also says that hospitals should build multiple electronic links with physicians to provide many ways of supporting the practice of medicine. "Electronic prescribing, order entry and referrals should be part of an initial EMR rollout," Marino writes. "Subsequent phases can introduce features such as electronic test results, emergency department and outpatient reports, and hospital inpatient reports and discharge summaries."

Hospitals can and should create similar links with patients, he adds.

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