Seven Ways to Get Value From Your EMR

EMRs were thrust once again into the national spotlight when the Obama administration committed nearly $19 billion in stimulus funding for health IT as part of the American Recovery and Reinvestment Act of 2009. The objective is to use electronic medical records to make the health system more efficient, safer for patients, and, ultimately, to reduce costs and improve quality.

While EMRs have the potential to meet those objectives, implementing the technology simply isn't enough. A lot depends on how organizations use the systems, which is why the HITECH Act calls for providers to be deemed "meaningful users" of certified EMR technology before they qualify for stimulus dollars. The legislation uses a carrot and stick approach. It offers providers incentive payments if they can meet the meaningful use criteria, however, organizations and physicians that are not meaningful users of HIT by 2015 will start incurring penalties.

Implementing the technology in a short timeline will be difficult for providers. But the real challenge will be getting value out of the systems put in place.

For the July issue of HealthLeaders magazine, I spoke to executives at four hospitals and health systems about how they were moving past implementation and getting value from their electronic medical records systems ("Where's the Value?").

Here are seven tips they shared with me.

1. Commit to the project. Organizations need to get EMR systems in place quickly, but done the right way. "That takes a good vendor, IT staff, capital, and management support," says Tom Smith, CIO, NorthShore University HealthSystem. "The key for us was having top management commit the organization to the project."

2. Let clinicians take the lead. Once these systems are in place, it is up to physician and hospital leaders to use the system in the best way. Include physicians and nurses in all phases of the project, such as vendor selection, workflow analysis, and implementation. "The role of IT is to get it implemented, make it reliable, and respond to user requests," says Smith.

3. Make the data easily accessible to the end user. NorthShore's strategy was to make the system available to physicians, nurses, and pharmacists everywhere—at home, in the hospital, or in a hotel room. If electronic medical records are easily accessible, clinicians will find ways to use the technology in a meaningful way.

4. Emphasize quality and patient safety. Public reporting of patient safety and quality core measures is a great motivational tool, says Peg Reiter, CNO at St. Luke's The Woodlands Hospital. Similarly, data about performance and process improvement should be as transparent as possible, says Ron Short vice president with Good Shepherd Medical Center. "Physicians want to be recognized for best practices, not as lagging behind them."

5. Continue training. The more comfortable clinicians are with the system, the more likely they are to access all of the information available to them when caring for the patient, says Reiter. Senior leaders at St. Luke's make sure that nurses know how to find a consult by a pulmonologist on an ICU patient, for example, by rounding on units twice a month and asking staff to find specific information in its electronic medical record.

6. Be deliberate. Think through all of the implications of what has to be done in order to have a smooth transition, says Robert Kiely, CEO at Middlesex Hospital. When hospitals rush to implement IT without proper preplanning, mistakes often are made and "they wind up losing not only the purchase price of the system," but development costs if they have to put a halt to the system and go back to square one, he says.

7. Define success. Organizations should know what they want to accomplish, be able to identify key performance metrics, and be clear on how they define success, says Short.

Currently, there is a lot of HIT activity happening this week. Today, the HIT Policy Committee's Certification/Adoption Workgroup is giving its recommendations for standards and certification criteria that will enable the electronic exchange and use of health information outlined in ARRA. Also, on Thursday, July 16, 2009, the Meaningful Use Workgroup will submit a new set of recommendations for defining meaningful use of electronic health records to the HIT Policy Committee. If you have an opinion on what it will take to use the technology in a "meaningful" way or would like to comment on the HIT Policy Committee's recommendations, please drop me a line at the below e-mail.

The committee's recommendations are nonbinding but they will provide guidance to the Centers for Medicare & Medicaid Services, which will ultimately establish the definition for meaningful use.