Monday, January 18, 2016

Being Honest about Electronic Health Record Costs

In the article Hospitals face budget woes with switch to electronic records, Brigham and Women’s, one of the most famous and profitable hospitals in the USA, lost money in their transition to an Electronic Health Record.

The article is interesting and hospital administrators should pay attention.

            The Electronic Health Record is potentially a great tool when built and used properly. These advantages have a steep price tab when all aspects are factored in.
  1. Cost of system (including hardware and software)
  2. Cost of ongoing Support
  3. Data storage (consider HIPPA compliance)
  4. Training
  5. Repeat Training
  6. Learning curves
  7. Difficult user interfaces, frequent updates. These require re-learning and workflow readjustments that are seriously expensive. 
  8. Costs of customization
  9. Hiring more personnel
  10. Getting providers to cooperate
  11. Keeping EHR costs within rising clinic and physician budgets.
  12. Matching the right diagnosis codes, right diagnosis, and accurate documentation.
  13. Over-coding and under-coding
  14. Charts that are written in “computer-eeze”.
  15. The additional costs of needed modules.  For example: Voice Activated Technology and/or other programs make enterprise systems more user friendly (sometimes).
  16. Malpractice worries with mega-data
  17. HIPPA concerns
  18. Computers and programs can be used to help solve problems but they do not accomplish this “magically”.
  19. Volumes of incoherent data collected
  20. Burn-out of the staff and providers
  21. ETC.

A great many such costs are hidden. We see a good number of task forces created to improve efficiency.  Often they accomplish that goal by jury-rigging work-arounds that only last as long as the task force. A year goes by, and the facility is back to ground zero.

Bottom line, the EHR is a tool; it is not a global solution.  Hence EHRs should be customized to meet the clinical needs of the providers and staff, first. The wishes of the accounting department can be addressed after all the patients are cared for.  

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