The case for implementing an EHR depends on your point of view. In this blog, I want us to consider the question from a CEO’s perspective. CEOs spend much of their time monitoring enterprise performance and preparing for and making decisions. This is as true for executives in health care as for those in automobiles and banking. Volumes have been written about these high level tasks and, for sure, I don’t have new insights to add to that body of knowledge. What I want to highlight is the crucial contribution information makes to CEO oversight and decision-making. Courtesy of Wikipedia, I define Information to be "the result of processing, manipulating and organizing data in a way that adds to the knowledge of the receiver." In the domain of health care, information must include data captured through an electronic health record (EHR). Here’s how this played out at my home organization, University Behavioral HealthCare (UBHC).
In the mid 1990’s UBHC faced the surging managed care environment with its demands for effective care at lower prices, its requirements for accountability for documentation and outcomes and its focus on customer satisfaction. Our CEO recognized that in order to succeed in this environment the organization needed to use information to:
- Establish and monitor care and productivity standards
- Optimize and monitor billing
- Identify service supply and demand trends
- Measure treatment efficacy and patient satisfaction
He further recognized that to accomplish these tasks, he needed the data to be comprehensive, detailed, high quality, and current. Relevant data from all functions of the enterprise had to be captured electronically for executive management control and reporting purposes. For our CEO this case for implementing an Electronic Health Record System was compelling.
By July 2000, an enterprise-wide EHR has been implemented. All staff - 500 clinical and 400 support - worked primarily in the EHR. By 2003, more than 1,000 managerial, fiscal, control, QI and clinical reports were in use. Outsourced billing and transcription costs were eliminated, saving $1.4 m per year. Successful billing was increased 10% through monitoring the billing process for problems which would have previously resulted in denials such as a missing Diagnosis or Progress Note. Gross revenues per clinician FTE increased 50% due to the ability to schedule more efficiently, to track work being done and to assist documentation compliance with reminders and to do lists.
