Jeffery Daigrepont is the senior vice president of Coker Group. He presented on EHR and EHR conversion at Becker’s ASC 23rd Annual Meeting: The Business and Operations of ASCs on October 27.
The current state of the market is in flux. Established players have vanished from the scene, and as the market condenses so does support for EHR systems.
“There have been a lot of changes in the market,” Mr. Daigrepont said.
According to a study from the CDC, in 2013, 78 percent of office-based physicians used some type of EHR system, which was up from an 18 percent adaptation rate in 2001. Of that 78 percent, 48 percent reported the systems met the criteria for a basic system, up from 11 percent in 2006.
Of the office-based physician, 69 percent reported they intended to participate in meaningful use initiatives, which was seen through a related increase in physician adaptation of Stage 2 EHRs.
And Mr. Daigrepont has other numbers to support the increased adoption of EHR systems, but with all the statistics there is a flaw.
The flaw stems from self-reported data from EHR companies. A survey conducted by the Coker Group reported that 925,000 EHR systems were purchased, but the group estimated the actual total was only around 675,000.
So what caused the variation? Mr. Daigrepont estimates it was healthcare organizations purchasing systems but never implementing them, and some corporate over-reporting.
“If it’s half of that number that means a lot of systems get sold, but don’t get implemented,” he said. Then when the systems are implemented, the warranty is often extended or the systems are outliving their relevant lifespan.
So what does a successful ASC do when it has to convert EHR systems or merge with another system?
Go in with healthy skepticism of the phrase “nothing will change after the merger.”
“Everything will change,” Mr. Daigrepont said.
But change shouldn’t elicit fear. If a center is merging with another established EHR system, some things Mr. Daigrepont advises successful ASCs consider include: Which EHR is the most modern, cost effective and physician friendly, among several others.
Mr. Daigrepont strongly advises against co-existing EHR systems. Although it’s less disruptive and allows for easier transitions, co-existing EHR systems “delay the inevitable,” and can be costly while creating mounds of duplicate records. A situation coexisting is reasonable is when providers are riding out their existing contracts.
After a decision is made to move to a new EHR, Mr. Daigrepont recommends taking a hybrid structured and non-structured approach to data migration. He recommends compiling the previous two to three years of patient data and implementing a structured approach which takes the current EHR and transfers it to the new system. He then recommends transferring the rest of the files in a non-structured approach which transfers several files in a hard file form, like a PDF.
Despite an uncertain and changing marketplace, EHRs, their related contracts and EHR systems should leave the successful ASC with nothing to fear.
Mr. Daigrepont will review EHR contracts of all Becker’s readers. For more information email him at jdaigrepont@cokergroup.com.
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