This article was originally published on dotmed.com.
September 29, 2023
By Matt Duffy
The situation for U.S. healthcare organizations remains dire. Approximately one-half of hospitals ended 2022 with a negative margin. More than 1.7 million people quit their healthcare jobs, according to U.S. Bureau of Labor Statistics data. Persistent staffing shortages are part of a vicious cycle – overburdened staff grow more burned out, patient safety is at risk, and financially strapped hospitals lose more and more revenue.
Before these issues were accelerated by the pandemic, electronic health records (EHRs) were promised to be the magic bullet, evidenced by the wave of mandates over many years. Yet, they fall short. While each new feature promises to make things easier and faster, it does the opposite. Instead of improving workflows for coordinating and delivering care, the ever-increasing requirements for clinical documentation, though ultimately helpful, are a frustrating burden on clinical staff.
Of course, EHRs have become a critical foundational technology in our healthcare system. But it’s time to acknowledge what they are and are not. EHRs are documentation repositories: systems of record that support billing and compliance. EHRs can certainly alert and notify the care team regarding what needs to be done and/or work they need to do. But providers need more than just a system to alert them to protocol variances; they need a system to automatically execute those actions.
Complementing EHRs with powerful automation, creating an agility layer that leverages current IT investments, is the path forward. Consider the impact across the entire clinical staff and hundreds of patients by putting all care coordination into action with precision – and reducing the time spent charting from 11 minutes to two minutes per patient case. Here is what automation brings to the table to address three EHR gaps while improving care delivery and outcomes.
Unburden the workforce from unnecessary tasks
It’s abundantly clear that praising our healthcare workers for “stepping up” and going “above and beyond” is not a solution – and it has taken a toll on the workforce and the care they deliver to patients. In addition to the demands of documentation, fragmentation further complicates orchestrating care across an organization, requiring more handoffs and more follow ups, adding to the frustration felt by care teams.
Instead, we need to make their jobs easier, so they can focus on the work they are trained to do, leading to the best possible care outcomes. There are many tasks that can be removed from daily workloads by automating them. For example, typically manual tasks in the preoperative process, such as checking the patient’s record, gathering information from the patient, ordering labs, can be part of an automated process that is personalized to the needs of each patient. This automation means that by the time the provider engages with the chart (in the EHR), all the data is captured, orders are pending, and a quick final review can move the patient along in the process.
By automating manual tasks such as phone calls, texts, emails, and other activities, workflows and events, the technology burden for navigating and documenting care can be dramatically reduced. Rather than feeling constantly behind and overwhelmed, care teams participate in a more efficient, proactive process, where the technology within their workflows makes it easy to know what to do, and when, for their patients and eliminates time wasted chasing down details and following up with others.
Reduce costs by saving time and avoiding waste
While automating tasks reduces the burden on care teams, it also reduces the cost of care in ways EHRs alone can’t. Standardizing care using best-practices protocols is one approach to reducing costly variations in care. Most organizations have protocols in place to ensure the right care for each patient. However, organizations struggle to implement these protocols at scale because of staffing realities.
For example, when a patient needs a routine procedure, such as a colonoscopy, there is a standard protocol to assure the patient arrives prepared and ready for care. Given that the EHR may not have all the latest information, current medications need to be confirmed with the patient, requiring manual review and follow up. It’s easy for things to get overlooked, such as a patient taking blood thinners not reflected in the EHR medication list. If the patient arrives, but the procedure can’t safely proceed, time and resources are wasted.
Through automation that works in harmony with the EHR, the sequence of tasks for each patient adapts as needed without letting anything fall through the cracks. If the patient confirms current medications do not include blood thinners, no one needs to spend time following up. And, if the patient updates her medication list to include blood thinners, the appropriate care team member is alerted as the pathway adapts to new information. This way, the right steps can be taken proactively, so she can still arrive properly prepared for the procedure. Additionally, clinicians can spend their time with the patients who require their expertise, rather than chasing everyone just to gather data.
This level of clinical workflow automation increases efficiency and productivity while avoiding costly waste from lastminute reschedules and avoidable care delays. As noted above, this approach reduced patient charting time to two minutes per case. When taken at scale, efficient use of time and resources reduces costs system wide.
Increase revenue by orchestrating the full journey
Another challenge for EHRs is that they don’t have all the information about each patient. Given that more than a third of Medicare patients see five or more physicians a year, key information may be spread across multiple EHRs. Fragmentation makes it difficult for providers to form a holistic view for managing a patient’s care.
Consider the example of a patient experiencing chest pain. Once his primary care provider refers him to a cardiologist, that may lead to a series of tests and an order for a stent. In many cases, the health system may only have visibility to the stent order. All the other activities – and the associated revenue – may go to other providers in the market.
With automation integrated with the EHR, a clearer picture can be assembled with information gathered from the patient. From the start of the care episode, the care team can guide the patient through the appropriate steps from labs and imaging to medications all the way through follow-up care, keeping those services and revenue within the health system. It’s not only a better experience for the patient, but it also captures new revenue that might have been lost.
Making the most of technology investments
While health systems have seen benefits from the investment in EHRs, it’s time to accept their fundamental limitations. Healthcare providers that have augmented their EHRs with clinical workflow and process automation that drive precise action have seen how this automation seamlessly orchestrates care and delivers reliably consistent, quality outcomes. When employed at scale across an organization, the direct, measurable improvements are significant. For example, health systems have achieved 66% increases in care team capacity, 20% reductions in cost per case, and 80% improvements in patient experience with clinical workflow automation. Such dramatic improvements in workforce productivity, costs and revenue are what’s needed for healthcare organizations to not only survive but also thrive in today’s environment.