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EMRs and the Transformation to Patient-Centered Care

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Ralph Henderson, president, healthcare staffing, AMN Healthcare

“The times, they are a-changin’,” the great songwriter/philosopher Bob Dylan once wrote. That’s certainly true in our field. Over the past few years, technology has changed healthcare delivery in ways that even healthcare leaders could not have envisioned just a decade ago—from the abundance of clinical applications on mobile phones to telemedicine, digitized medical records and more.

Now, as more and more healthcare providers are finding their way through the complicated process of implementing and upgrading their electronic medical records (EMRs) systems, we can start to see the enormity of this change—for the present and future.  Not only does an EMR implementation have a profound impact on how clinicians perform their jobs, but it has implications far beyond one facility’s walls. It is part of an overall transformation in how patients and providers interact and how healthcare will be delivered in the digital age. 

EMRs, or electronic health records (EHRs) are a key component in connecting hospitals, physician practices, pharmacies and government agencies with the patients who need their care. And they are a necessary step toward the ultimate goal of improving outcomes and helping patients manage their own health.

Worthwhile investments in the future

Thanks to the 2009 American Recovery and Reinvestment Act (ARRA) and more recent funding allocations in health IT, achieving meaningful use of electronic health records is one of today’s top priorities for hospitals and healthcare systems. Yet EMR adopters have a lot more to look forward to than just some federal funding, according to the organizations that have gone before them.

Out of the 66 hospitals that had achieved a “complete” EMR by the end of 2011, as described by Stage 7 of the Healthcare Information and Management Systems Society (HIMSS) AnalyticsTM EMR Adoption Model, 10 case studies highlight a variety of clinical and operational benefits gained through the process. In virtually every case, the hospital leaders said improving patient care was —and still is—the driving force behind their efforts. And many of their results reflect that, with everything from significant reductions in medication errors to shorter patient admit times, shorter lengths of stay and fewer readmissions.

These case studies coincide with our own experiences, as well.

In the many EMR system conversion projects that AMN Healthcare has been a part of, one consistent expectation cited by our hospital clients is that implementing electronic records will help them provide the best patient care; thus they are willing to make the short- and long-term investments to get there.  They are also careful to help their clinicians understand that this is not an IT-driven program, but a patient-centered program, in order to gain their full investment in the project.

Recent trends

According to the HIMSS Analytics Database, approximately a quarter of all U.S. hospitals are still relying on paper-based documentation, and have yet to achieve Stage 3 of the EMR Adoption Model, (related to meaningful use incentives), and close to 95 percent still need to achieve the final two stages of the adoption model.

We obviously have a long way to go, but studies are already starting to show some of the patient and provider benefits for those who have made the EMR conversion. 

In the April 2011 issue of Pediatrics, for instance, researchers from Stanford University School of Medicine and Lucile Packard Children's Hospital in Palo Alto, Calif., found that evidence-based, pop-up reminders in EMRs reduced unnecessary blood transfusions by 460 and saved $165,000 in just one year. 

The study’s authors saw potential applications in many other clinical areas, as well.  Increased efficiencies from EMR systems have been shown time and time again, from Modern Healthcare’s “Most Wired” hospitals list on down to those that have just implemented their first electronic charting system. The trick is to get through the conversion process and come out on the other side.

Learning from best practices of the early adopters of EMRs, most hospitals have begun to bring on travel nurses, locums physicians and other per diem healthcare professionals to supplement their clinical teams during training and go live.  These flexible professionals, such as provided by AMN, come with experience with various EMR technologies as well as the clinical skills to assist with patient care while core team members learn the systems and work through the change management process. 

After spending millions on software and system configuration, this small investment in staffing can make the implementation process go smoother, accelerate user adoption, improve patient experience during go live and accelerate the hospital’s return on investment. 

So when it’s time to implement a new EMR system, hospital executives will want to be sure that their nurses, physicians, pharmacists and allied health professionals are fully invested in the project, and that they are sufficiently staffed to help make the transition/implementation process a success. 

After all, it’s a critical step for any facility and its patients—and for healthcare as a whole.

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