EHR systems can store comprehensive patient information digitally, streamline workflows, facilitate information sharing, integrate with other components in a patient’s care, and more. The adoption of EHR systems has skyrocketed ever since the Centers for Medicare and Medicaid Services (CMS) incentivized its meaningful use.
The global EHR market is set to reach over $43 billion by 2032. For perspective, over 95% of hospitals in the US use EHR systems as opposed to 45% physicians in 2010. Using EHR systems has multiple key advantages over EMR or paper records.
This article covers EHR systems in context of increasing revenue and productivity for hospitals and practices with real world examples and use cases. Read on to know more.
Understanding EHR Systems
To understand EHR systems, you need to have a bit of context. The hospitals and private practices before the adoption of EHR systems were mainly using paper records or EMR (Electronic Medical Record) systems.
EMR systems work the same as EHR systems in that they’re used to store patient data including medical history for use within a practice. They’re not meant to be shared outside of the practice. For example, if you regularly see a doctor who used an EMR system, your data won’t be transferred when you go see a new doctor. EHRs don’t have this limitation, and they’re designed for interoperability.
Before HIPAA (1996) and the HITECH Act in 2009, most organizations and practices were still using EMR systems and paper records. And then the HITRUST incentivized the adoption of EHR systems and emphasized its meaningful use. This led to nationwide EHR adoption at scale, and fast-forward to today, where over 95% of hospitals use EHR systems in their practice.
Here is how EHR systems are increasing efficiency and profitability on a global scale.
Efficiency and Productivity
A patient’s visit to their healthcare provider doesn’t seem like a big deal on the surface. But there are a lot of moving parts in that process. From the first point of care where the nurse takes down information from the patient like medical history, insurance details, etc., to the final bill, the whole process is prone to administrative errors if done manually.
In comparison, EHR systems eliminate the need for manual entry and automate the whole process. The information has to be entered correctly once, and that same information is used across the board whether it’s for diagnosis, treatment, or insurance claim by the healthcare provider.
By automating tasks, EHR systems save time and manpower needed to manually enter the details every step of the way. This is especially helpful during claim filing where a seemingly inconsequential error can lead to rejected or denied claims, overburdening the healthcare provider because they have to file the claim again.
According to research published in the Journal of the American Medical Informatics Association, the use of EHR made patient encounters more efficient by 12.6% to 45.5% per patient.
Another benefit of using EHR systems is reduced paperwork that not only saves paper but also frees up physical storage space. While the overall impact of EHR systems vs paper records is debatable since EHR systems use data centers that consume energy. But in the longer run, your practice’s carbon footprint will arguably be less than paper consumption.
Then we have improved communication because of the interoperable nature of EHR systems. Even if a patient switches their healthcare provider, their data can be transferred to the new provider. This ease of communication leads to better coordination and improved care for the patient.
Revenue Cycle Management
Due to the high cost of medical care, insurance is strongly encouraged in the US. And the US healthcare system works closely with insurance companies for claims. A healthcare provider is supposed to verify insurance details of every patient, identify and assign correct medical codes, and file the claim to the patient’s insurance company to get paid for the services rendered.
If, by any chance, the submitted claim contains an error, the insurance company rejects it. Then, the healthcare provider has to file it again after making necessary corrections. The whole process requires great attention to detail, otherwise the healthcare provider risks increasing their own administrative burden.
Providers spent over $10 billion chasing denied claims across all payer types in the healthcare industry in the US in 2022, according to a survey.
Modern EHR systems now often involve a billing module integrated into the EHR for revenue cycle management. Keep in mind that not all EHRs have this by default, but it’s an add-on offered by some companies. Then, some other companies that specialize in medical billing also exist that take off the whole revenue cycle management off your plate.
This also helps with specialty-specific regulations. For example, a general checkup has a standard code. But the code will differ for a complex cardiac procedure depending on the technique used by the cardiologist.
And any incorrect coding can lead to rejected claim, which is counter-productive and wastes resources. The same way, a cardiologist would benefit more from getting an EHR with integrated cardiology billing services module.
Regulatory Compliance and Risk Management
HIPPA requires strict compliance with all regulations to ensure maximum privacy for the patients. Any breach resulting in unauthorized access to protected health information (PHI) can land providers in a lot of trouble depending on the severity.
The compliance, while mandatory, can significantly increase the administrative burden of hospital staff, if done manually. Modern EHR systems have built-in robust security measures like data encryption, secure access controls, and regular security audits, to protect patient data from breaches and unauthorized access.
This not only ensures that PHI stays protected but also reduces the financial impact of penalties in case of non-compliance.
Data Analytics and Decision Support
Since EHRs store comprehensive medical data including a patient’s history in detail, healthcare providers use this data to make better informed decisions. Some companies are using these insights with their AI models for predictive analytics.
Healthcare providers can anticipate patient’s needs, allocate resources accordingly, and improve preventive care.
This technological breakthrough can lead to better decisions that would ultimately improve the overall patient experience. This is just one aspect of it. These data sets can also be used to identify revenue opportunities. For example, entities associated with the revenue cycle management can identify high-demand services, streamline the billing process, and increase their profit margins.
Also, these insights can offer decision support for resource allocation, improving patient care, operational improvement, and more.
Case Studies and Real-World Examples
There are tons of examples and success stories of effective EHR systems being used to increase profitability and make processes more efficient.
Kaiser Permanente CIO Philip Fasano, in his book, “Transforming Health Care: The Financial Impact of Technology, Electronic Tools, and Data Mining” expands on the successful implementation of EHR into Kaiser Permanente. This project took over $4 billion dollars over the span of a decade. And now Kaiser Permanente has one of the largest health systems by revenue in the US.
There are no duplicate tests, and the concerned primary care physicians and specialists all have access to the same medical history where everything, even an X-ray is stored digitally. If a patient decides to leave the hospital, the hospital hands over their health records stored on an encrypted thumb drive. They can take this thumb drive to any other doctor who will see the medical history for better diagnosis.
Another survey by MGMA found that physicians who used EHR systems for billing saw a 60% rise in revenue.
Challenges and Considerations
Most innovations come at a cost, and that applies to EHR systems as well. Transitioning from a pen and paper record system to EHR comes with a learning curve, which might seem steep to some users.
Administrative Challenges
The healthcare staff will need a bit of time to adjust to the new normal where everything is stored digitally. While this may cause some delays and possible confusion at the beginning, it gets sorted once the staff gets the hang of things.
Compliance
The medical industry in the US is heavily regulated and unauthorized access to sensitive patient’s data is a punishable offense. This is why every entity involved in a patient’s care must comply with all the necessary standards.
HITRUST, in the US, offers its Common Security Framework (CSF) to help organizations compliance and risk effectively. This framework includes various standards like HIPAA, ISO, NIST, and PCI.
Customization
Another thing of note is that while most of these EHR systems are highly customizable, excessive customization can lead to a complex user interface that’s confusing for the end users. So, you should aim for striking a balance between functionality and customization.
Way Forward
Here are some strategies to help you overcome these challenges.
Training and Support: Invest in interactive training programs to ease the transition and improve user proficiency.
Phased Implementation: Roll out the system in phases to manage costs and allow for adjustments later on when you have enough feedback.
Regular Security Audits: Conduct periodic security audits to identify and address vulnerabilities, if any.
Standardized Processes: Implement standardized workflows where possible to simplify use and maintenance. This especially helps new joiners quickly adapt to your organization’s structure.
Final Words
Now you know how EHR systems are increasing profitability in the healthcare sector. With effective EHR systems, you can minimize the administrative overhead, improve patient care, ensure regulatory compliance, provide insights to make informed decisions, and more.
All this ensures maximum efficiency for long-term sustainability and financial growth. Be sure to choose an EHR system that’s tailored to your practice’s needs and requirements.
