Transforming clinical practice is challenged by the multitude of opportunities to make things better. Healthcare is in crisis with high costs or inconsistent quality. Additionally, for many, accessibility to healthcare is lacking. To date, healthcare reform has focused on how it’s paid. With a focus on payment, the considerations of care cost are always primary. There should be no doubt that the cost of care becomes a focus of transformation.
The future of healthcare payment is the topic of much debate with providers scrambling to secure any advantage and position themselves for the improved care delivery of tomorrow.
Many providers believe that the only thing standing between us and a completely transformed healthcare system that has higher quality and lower cost is the lack of Electronic Health Record (EHR) systems in every provider’s clinic.
There’s no question that many aspects of care coordination and quality improvement are very difficult for healthcare providers to deliver without appropriate health IT support. The inefficiency of paper is well-known.
But merely having an EHR doesn’t guarantee that providers will, in fact, deliver better care to patients or more effectively coordinate hospital care and discharges. The provider’s practice and/or hospital must still redesign the actual processes of care to achieve those goals. The EHR can make that possible, or at least much easier, but only if the EHR is designed in a way that actually supports the improved care processes.
And there is the problem — it’s impossible for EHR systems to be designed to support the future improved care processes, when the improved care processes don’t exist. At best these systems match the way providers work today, rather than the way we want them to work in the future.
Fitting the electronic systems into clinical processes and expecting the result to be improved care has not been working. To impact quality electronic systems must be the tools to learn by and they should be developed and implemented as integral parts of quality improvement initiatives, ideally at a regional level, rather than provider by provider.