Stretch Your EHR Investment

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Stretch Your EHR Investment More than Just a Data Warehouse BY ALLAN STRONGWATER, M.D.

With all of the current focus on healthcare technology, it likely comes as little surprise that 8 of 10 physicians had implemented—or at least planned to adopt—an electronic health record (EHR) as of 2014.1 Considering that EHRs only began to emerge in the 1990s, this statistic speaks volumes about the rapidly accelerating change of pace in healthcare IT. Consequently, most hospitals and health systems are experiencing a significant transition in their thinking about EHRs. The question has changed from, “Should we implement an EHR?” to “How do we maximize our substantial EHR investment?” One answer is to stretch your EHR’s use by leveraging a clinical decision support (CDS) platform to improve care quality and efficiency.

Stretch your EHR’s use by leveraging a clinical decision support platform to improve care quality and efficiency. At its core, a CDS system augments the EHR by continuously analyzing a patient’s past and present medical information against best-practice guidelines and advising clinicians when their EHR entries indicate a deviation from those best practices. With the addition of CDS, the EHR becomes more than just a recording mechanism and data repository, delivering its data as a real-time clinical advisory system. Some can also 46

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generate performance reports to further guide increases in efficiency and compliance. All of this ultimately enables clinicians to best leverage EHR technology, streamline processes, improve patient safety, save time, and reduce costs. To fully understand where the forefront of EHR and CDS technology is today, however, it’s helpful to first take a brief look back.

The CDS Story Prior to the 1990s, most hospitals and health systems functioned using paper medical records and rudimentary computer systems for accounting and billing. Rarely did the mainframe computers of the day store such clinically important data as radiology images, for instance. There were few electronic interfaces from patient equipment to medical hardware. Although some physician notes found their way into the computer by the early 1990s, widespread use of computerized physician order entry (CPOE) was still years away.2 By the mid-1990s, the role of the computer in health care was no longer limited to accounting. Processors were finding their way into all kinds of medical equipment. For the first time, hospitals and health systems began to tap into the technological safety advantages offered by applied computing. Software developed for hospital pharmacy applications, for example, helped minimize drug-to-drug interactions and track patient allergies. Warnings about potentially adverse effects could then be presented. Proper dosing

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