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Creating a Story of Value About Your EHR

A message from StarBridge Advisors:
As we have learned from disruptive and unanticipated disasters of the past, the initial reactions are often shock, fear of uncertainty, concern over the loss of control, and a strong desire to get back to “normal.” The reactions to COVID-19 are all of these and more. All of us at StarBridge Advisors have spent our careers in healthcare.  Many of our families and friends are healthcare heroes, a term that has special meaning to us.  We watch them bravely go to their mission-driven workplaces to provide care and support to those patients and families stricken by the COVID-19 virus. 
In these turbulent times, we at StarBridge thought the act of publishing our blogs is a reminder of the importance of routine. Our focus on activities of the future is an important way to express our confidence in our coworkers’ abilities to get through this crisis. 
That said, we also want to make sure you have additional information and tools to help you navigate through this pandemic.  Please visit this website hosted by This Week In Health IT that provides up to date information, lessons learned, and some important practical and pragmatic best practices for health IT leaders. 
Thank you again to our healthcare heroes and the families and friends who are caring for and supporting them. 

Organizations continue to make significant financial investments in Electronic Health Records (EHRs) despite current negative perceptions and links connecting them to physician burnout and their shortcomings in user experience. Organizations can craft stories about their implementation and use of clinical technologies that are either positive or negative.  We are seeing health systems launching work to create platforms for connecting applications and tools that help to consolidate clinical and business activities into a platform with a potential to efficiently meet the needs of the individual stakeholders and shape a positive story of the impact of EHRs and Health IT. We currently see the clinical value of telemedicine applications during the COVID-19 crisis, which are most effective when they are linked to the EHR platform. Data suggests clinicians now want more clinical functions and workflows rolled into more effective EHR platforms. And how can these systems support the efficient delivery of value-based care? In the current environment it becomes imperative to more effectively manage costs so that those we serve can afford the care that we provide. Value should be the primary focus and the ultimate measure for improvement.

So how can these organizations better harvest value from their EHR platforms? My focus here will be on delivering clinical value, which will be essential for health care organizations that will be successful in an increasingly challenging environment. We hope that vendor technologies and platforms will continue to mature and improve in terms of usability. But what can we do now that will pay dividends and deliver value for organizations?

First, this work takes a very deliberate and strategic organizational approach to EHR and workflow optimization and value realization, highly functional Informatics and data governance, as well as ongoing development of more robust analytics capabilities. The team or teams to execute this work must be capable, visibly empowered and supported by the organization. The value of leveraging the EHR for this work can easily be overlooked or lost in competing priorities, and we also know that EHR data is not yet widely used or exploited. The foundation for this work should ideally be laid at the implementation phase of the EHR but is generally considered as part of optimization initiatives so can be undertaken at any point in the EHR project.

Deciding when and how to invest your company’s scarce resources in projects like this is of strategic importance. To do this, you must align EHR workflows and clinical content to support organizational KPIs and goals. It is essential to identify and understand the functionalities that are essential for optimal and patient-centered clinical practice within the organization, and opportunities for improvement. Thinking broadly and imaginatively is a good practice in designing such projects.

Successful organizations need to build, develop or leverage high performing teams to execute. These teams should align their efforts with existing organizational performance improvement and project management framework and structure, but specifically one must consider how you can use these tools to do this collaborative work with clinicians. The teams or leaders must have trust and credibility with clinicians and have a governance structure that engages them.

The first message to send to your clinicians as you embark on these projects is that your goal is to work collaboratively with them to deliver value for them while supporting best care for patients without adding to their cognitive burden.  It is also important how various clinical and business scenarios might interact with or impact workflows. This supports efforts to recruit and engage effective project champions based on the goals and targets of the project. I also emphasize that the messaging to physicians should be first and foremost about collaborating to improve quality of care while empathetically designing interventions to support these goals.  In addition, it is  also important to put this in the context of value-based care as the target goals might include specific targets such as reducing utilization of an over utilized diagnostic study or medication but they also need to share cost savings metrics as well. Seeing both kinds of data crafted into an effective story can be gratifying and reinforcing for physicians as well.

Ultimately, such projects must be linked to goals for improving outcomes for patients to be sustainable and the story that emerges from these efforts can be rooted in value creation . In a future post, I will share more about tactics and execution.

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