Since the Enactment of the ARRA and stimulus package, which offered financial incentives for Eligible physicians and hospitals, the adoption rate of EHR has significantly increased. According to a report by the ONC in December 2012, there has been a steady increase in physicians adopting EHR. According to the data published (http://www.healthit.gov/sites/default/files/onc-data-brief-7-december-2012.pdf), since 2009 and as of 2012 two-thirds of physicians had adopted computerized capabilities such as electronic medication lists and drug interactions in the surveyed physician’s group.
One challenge remains the same for physicians and that is the process of selection of an EHR solution to help them achieve meaningful use. There are several critical steps that must be taken in consideration as part of this careful selection process and some of the steps include the following:
-Performing a practice readiness assessment
-Review its plan and review GAP analysis
-Review, and perform EHR comparative analysis to review functionality and ROI
-Implement the EHR solution of choice
-Post Implementation review and optimization
However as part of this process there are several stages that take place and will have long-term impact on the organization. One of those stages is defining which EHR implementation model should be selected. There are currently several available implementation path when it comes to EHR:
Software as a Service/Cloud based EHR:
Physicians can leverage vendor hosted EHR systems that are available via Citrix or terminal services to the workstations and eliminates the need for a significant capital investment on the hardware infrastructure within the facility. Within this same model, there is also the availability of cloud and web based EHR system that provides the application via standard Internet browsers.
Outsourced Billing with on premise EHR: In this model which is commonly offered by billing providers and revenue cycle management groups enables the practice to go on an EHR system but outsource all their billing roles and activities.
On Premise EHR implementation:
Having the EHR data hosted internally is a common choice made by many. While this approach requires some significant investments up front, it provides improved performance and may in many cases required more support and maintenance of backups, DR planning and other internal IT functions.
Hospital Hosted implementation with Add value services: A fourth model has been available around large health systems and that is the IDNs offering EHR to the surrounding independent physicians. By offering the same EHR system that is being used within the hospital physicians are able to get the benefit of gaining immediate access to relevant hospital data for their patients, which traditionally would have required interfaces and connectivity to HIEs.
The selection process of an EHR system can be intimidating at first. There are many useful resources available from the ONC such as (http://www.healthit.gov/providers-professionals/ehr-implementation-steps) or third party consultants that can provide valuable assistance. A successful selection would likely mean a successful implementation as well as improvement in care, safety and workflows.