Speed: The Key to EHR Implementations

By Bair, Chris | Addiction Professional, March-April 2010 | Go to article overview

Speed: The Key to EHR Implementations


Bair, Chris, Addiction Professional


Thousands of addiction and mental health treatment providers across the country soon will be required to adopt an electronic health record (EHR) to satisfy business, clinical, and regulatory requirements. Faced with budget cuts, overextended staff, and limited IT expertise, these organizations might see successful implementation of an EHR as a daunting challenge, but it doesn't have to be.

One of the most important (yet most often underappreciated) aspects of running a successful EHR project is speed. For a traditionally resource-constrained organization such as an addiction treatment provider, the ability to dedicate one's best resources to a project that can be quickly completed increases the likelihood of a successful implementation, and in turn better long-term results post-implementation.

The reality for providers

Every behavioral health provider executive planning to implement an EHR has heard the disheartening odds: An estimated 70 percent of the agencies that made the commitment to move to enterprise EHR and billing systems, whether commercial or "home-grown," over the past 20 years have failed to fully operationalize their chosen system.

Why has the success rate been so low? The primary reason is that behavioral health and human service providers have been historically underfunded and understaffed, particularly for IT projects. These statistics from the 2009 Behavioral Health/ Human Services Information Systems Survey, conducted under the direction of several behavioral health provider associations and the Software and Technology Vendors' Association (SATVA), tell the story. Behavioral health providers:

* Spend only half as much as primary care providers on health information technology (HIT);

* Employ only about one-third as many IT professionals as primary care providers do;

* Expect to spend even less on HIT in 2010 because of budget cuts, reduced reimbursements, and higher patient volume; and

* Would increase overall HIT spending if resources were made available.

Also, the traditional software model has the wrong goal-alignment from the start. Traditional software implementations (whereby the provider purchases licenses, hardware, and services from the vendor up front) create little incentive for the vendor to conserve an agency's time or money. Prepayment front-loads the provider's expense, to the vendor's benefit.

Furthermore, on-premise software vendors stand to gain when projects run over budget despite the fact that these same overruns put the project at risk for the provider. On-premise vendors lack the motivation to quickly deliver a system that users can skillfully utilize. And what happens to providers when EHR implementations go over budget and behind schedule? Agency resources--already stretched thin--are taxed to the breaking point, and another addiction/mental health agency joins the 70 percent of providers that fail to operationalize their EHR system.

[ILLUSTRATION OMITTED]

Given today's economic environment and forthcoming EHR requirements, providers do not have the appetite or the budget for multi-year projects and hundreds of thousands of dollars in custom software. Agencies need to see value from their system investments as quickly as possible.

Case example

InterCommunity, Inc., an East Hartford, Connecticut-based behavioral health provider, struggled for three years with an on-premise (client/server) EHR implementation. …

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