Road bumps plague hospital EHR replacements

Replacing an inpatient electronic health record system, while increasingly popular, has a significant impact on a hospital, but executives and non-management level personnel don't necessarily see eye to eye regarding the effect, according to a new report from Black Book Rankings.

The report, released April 29, surveyed 1,204 hospital executives and 2,133 "user-level IT staff" that went through at least one big EHR system change in the last four years. While there may have been some "modest successes," the respondents' views regarding the transition appear to be mixed.

For instance, while only 5 percent of hospital leaders said that the replacement process negatively impacted care, 90 percent of nurses said that it reduced their ability to deliver hands-on care at the same effectiveness, and 62 percent of IT non-management staff reported a big negative impact directly attributable to the EHR replacement.

The respondents also reported that buy-in to the replacement EHR was "exaggerated". Eighty percent of IT staff felt they had to "coerce" network doctors to change; 78 percent of non-physician executives admit the clinical buy-in they were oversold never materialized.

What's more, almost two-thirds (63 percent) of executives or their peers felt that their jobs were in jeopardy during the process; 7 percent of management level or higher personnel, or their peers, were fired or asked to resign because of cost or productivity issues. Roughly one-fifth (19 percent) reported that their facility laid off staff due to implementation delays, cost overruns, underestimated budgets and lack of trained personnel.

Respondents also said the level of interoperability decreased after replacement.

Moreover, 14 percent of all hospitals said that they were losing inpatient revenue at a pace that wouldn't support the total cost of the EHR replacement.

"It was a risky decision as hospitals were facing the fact that they would not be back to their pre-EHR implementation patient volumes, inpatient or ambulatory, for at least another five years," Doug Brown, managing partner of Black Book, said. "No other industry spends so much per unit of IT on the part of the business that is shrinking the fastest and holds little growth as did inpatient revenues."

To learn more:
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