4 insights from HSTpathways' Tom Hui on EHR implementation & best practices for ASCs

In the second part of this series, HSTpathways CEO Tom Hui spoke to Becker's ASC Review on negotiating and implementing interoperability EHR systems and addressed common challenges ASCs face in the EHR space.

Note: Responses were edited for clarity and style.

Question: Concerning interoperability, how do you get all three parties committed? Do you find that organizations are often keen to work together?

Tom Hui: Commitment involves two software vendors and the customer requesting interoperability. Organizational leadership is critical. The customer will need to take ownership for the initiative to be positioned for success. When weak management and lack of ownership are present, the initiative will be expensive and take longer than necessary.

The customer must have a representative at meetings when decisions are being made; two vendors making decisions on their own is a recipe for poor execution. Vendors cannot be the source of motivation and drive commitment. Vendors can assist and provide the framework for a good statement of work. But their effort is giving the customer and the other vendor accurate and relevant information as well as actions for success. The customer’s organization must own the decisions and the execution. Sharing a project plan will help a customer understand their role and responsibilities.

Q: When setting up a system between a health system and an ASC, how do you sell the idea to each party?

TH: First, understand who is the leader and who is the follower — is it the ASC or the health system? Next steps are to go through a discovery phase. Health systems want to know ASCs are organized, have working knowledge, a depth of experience and can offer processes reflecting best practices.

For ASCs administrators considering replacement of paper charting with an EHR system, it’s important to evaluate applications designed specifically for that market. Planning and preparation are the two most important influencers of success.

Q: What are some unique challenges ASCs face in this space, and how do you recommend they overcome them?

TH: There are four challenges in particular:

1. Quality of patient care is the most frequently cited priority by ASCs.
2. ASCs are often challenged to present a return on investment for their decisions and investments.
3. Many surgery centers struggle with negotiating contracts, which effects their reimbursements and surgical volume, payer mix and case mix.
4. Concerning competitive contracting, administrators frequently say it’s a 'David (ASC) versus Goliath (insurance company) situation.' Successful negotiations depend on data and is an essential skill.

One-size-fits-all EHR solutions can create even more challenges. ASCs will want to look at EHR solutions that are designed specifically for the ASC industry. Beyond being designed specifically for the ASC industry, ASCs should look for EHR solutions that allow flexible charting. This means using a modular charting design that can be easily modified to align with the ASC’s workflow and accommodate future procedures.

The best EHR facilitates the clinician’s access to the most current clinical data, including the most recent documentation, medication lists, and allergy information. EHRs that allow concurrent charting improves data accessibility, improve patient safety, and user acceptance.

Q: If there was one thing you wanted ASC administrators to know about interoperability, what would that be?

TH: It comes down to value. The decision to incorporate interoperability is driven by a center’s value proposition and market strategy. Business objectives drive the decision to commit people and resources to adopt interoperability and make it successful. With a clarity of mission, one will bring the right people to the table. Start by asking 'Who are the project owners?' and 'Is it an IT driven mandate or a business-driven mandate?'

More articles on leadership:
SurgCenter Development forms 200th ASC partnership — Company in 'full-growth mode'
Illinois community may benefit from ASC, OSF Regional Vice President says — 3 insights
How Southern California Orthopedic Institute shifted total joints to ASCs using bundled payments — 5 insights

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