3 ways EHRs can reduce unnecessary care

Automated alerts in EHRs have reduced unnecessary tests at Virginia Mason Medical Center.

Not everyone is down on the often-maligned EHR.

In fact, two directors at Virginia Mason Medical Center believe EHRs can be a platform for “innovation and creativity.”

EHRs can make a significant impact on reducing unnecessary care and medical errors, A. James Bender, M.D., medical director for clinical informatics at Virginia Mason and Robert Mecklenburg, M.D., medical director of the system’s Center for Health Care Solutions, wrote in Havard Business Review.

The authors noted that computerized order entry helped Virginia Mason reduce confusing or incorrect physician orders “from 50% to near zero overnight." Furthermore, automated prompts have reduced the number of MRI and CT scans for patients with back pain, headaches and sinus conditions.

RELATED: Are EHRs a patient safety necessity or a barrier to care?

Since widespread adoption began in 2009 after the HITECH Act, the EHR has become a platform for innovative partnerships to improve quality of care and reduce healthcare costs, they added. Many of those initiatives revolved around three factors:

  • Establishing best-practice standards to reduce variation.
  • Embedding “hard stop” warnings to prevent unnecessary tests or procedures.
  • Shifting to value-based payment contracts—an effort that should be led by employers that are ultimately paying for healthcare services.

“Detailed prompts can standardize and improve care,” Bender and Mecklenburg wrote. “Evidence-based, best-practice guidelines are publicized for many common conditions but are often deeply buried in medical journals. The EMR can bring these guidelines to the point of care, directing practitioners in completing all necessary treatments.”

Usability and interoperability are the major pain points for EHRs moving forward, but industry experts are split on exactly how to achieve those objectives and what the federal government's role should be in fostering EHR innovation.