How can you quantify the problems you are having with your electronic health records (EHRs)?
EHRs are a necessity to stay viable in the era of healthcare reform and Certified Community Behavioral Health Centers (CCBHC). Many of you already have an EHR but are not happy for a variety of reasons.
End user complaints, security, system performance and functionality, limitations—there is no shortage of grumblings. What happens when it really comes time to part ways with your EHR vendor choice? How can you quantify, assess, document, and evaluate your current vendor to justify the expense (and agony) to your board of directors?
After acknowledging that no system is perfect, there are a number of considerations to ponder.
First is what I call the “relationship building phase.” The first year of a new EHR is critical to getting staff used to doing their charting differently and getting their brains around the concept of using a computer for a medical record. Figuring out how to really pull meaningful reports and manipulate the data into a usable format is a year one and two activity. But it isn’t really until years two and three that you can see what is challenging, or have created a well-developed “wish list” of new functionality for the EHR.
Sometimes, enhancements and improvements are just around the corner in an upcoming release. Other times, they are not. Years two and three are also the targets for being able to fully leverage the data in demonstrating how you are doing on key performance indicators, strategic plan objectives and outcomes.
Once you have some competency with the EHR, the next phase is the actual assessment. The goals for the assessment are to ensure the EHR can support the clinical tasks and the end users workflow with minimal constraints, adverse impact or compromises to patient safety. Yet it is larger than a simple satisfaction survey of end users.
So, how can we quantitatively evaluate our current EHR system and collect data for the decision-makers? An EHR functionality and end user assessment will give you an objective report of what is working or not. Elements covered in this assessment should include:
1. EHR Functionality Assessment: While many vendors will indicate “yes, we have this functionality,” how the item actually performs might be a different experience for the organization. Some of the functions may take three to 30 steps to complete, possibly creating inefficient workarounds. Weighted scores will give you a concrete picture of how the system is actually living up to its promise.
2. EHR Usability Assessment: This portion of the assessment focuses on the strategic mission of the organization, service lines and technology objectives. Again, measured instruments are used to collect the data to produce tangible results.
3. EHR End User Observation and Interviews: This element is optional during the assessment, but could potentially lead to critical clues in the EHR assessment that influence final recommendations.