EHR Technical Assistance Is Essential, Not a Luxury
Electronic health records (EHRs) are expensive to implement, and this is particularly true of enterprise-wide EHRs. But despite the high prices already paid, adequate EHR support often is not covered in the contract. If an EHR is dropped off at the practice like a new laptop, with nothing more than basic instructions and a “Good luck” wish, you are not likely to realize the full potential of the system. The “standard” support may not be adequate for implementation, let alone ongoing use.
For example, the study “Small Physician Practices In New York Needed Sustained Help To Realize Gains In Quality From Use of Electronic Health Records,” published in Health Affairs, “evaluated the early effects on quality of the Primary Care Information Project, which provides subsidized EHRs and technical assistance to primary care practices in underserved neighborhoods in New York City.” As stated in the study abstract, the authors concluded, “It took sustained exposure on the part of these practices and technical assistance to them before they demonstrated improvement on measures of care most likely to be affected by the use of electronic health records, such as cancer screenings and care for patients with diabetes.”
Sometimes, the issue is the quality of the support personnel. If this is the case, the hospital/medical practice should have the contractual option of changing personnel. More often, however, the necessary support hasn’t be contracted, in the first place. It is assumed that the hospital/practice personnel will have the time/expertise to pick up all of the implementation slack not provided by the EHR personnel. But as implementation problems erupt, enormous amounts of hospital/practice personnel time are burned to get things working, often without anything resembling best practice results.
The “best practice” approach must involve contracting for adequate support from the EHR vendor, as well as preparation for the time and effort required by personnel.