What goes into building an EHR for ASCs? 2 questions with CEO Tom Hui


Tom Hui is founder and CEO of ASC software company HST Pathways, which has been addressing surgery centers' unique needs for 15 years.

Mr. Hui spoke to Becker's ASC Review about the company's challenges and how it works to earn ASC clients' trust.

Note: Responses were lightly edited for length and clarity.

Question: What challenges did you face when developing HST Pathways?

Tom Hui: HST Pathways is in its 15th year, so the challenges really have differed depending on the time frame. Early on, our challenges had more to do with the financial crisis. During that same time frame, we were among the first of the cloud-based computing trailblazers. However, most individuals weren't familiar with what the cloud was back then. On top of encouraging investment during challenging economic times, we had to earn our clients' trust to demonstrate why it was better to put data into something they couldn't see versus an on-premise server.

The next challenge was when we decided to launch the eChart solution. We had to think through what the industry was needing that did not yet exist to cater to ASCs. For example, concurrent charting was not something that existed when we set out to design our system, but we knew it was a huge need for our clients. Concurrent charting took significant investment on our end so that we could make sure it worked properly, in real time, with visual alerts for the users. Nothing like that existed at the time, but I'm very proud of the end results.

The last challenge came as a result of customization. When you allow people to fully customize, you lose the ability to support the system, since every system will end up with a different design. To allow for some customization while maintaining the ability to support our clients, we came up with a concept called BLOCs (BLOC standing for "basic level of charting"), where we worked in partnership with nurses to design a system that had logical groups of information that were likely to be charted together. We're able to continuously add and update these BLOCs as new procedures are introduced in the surgery center setting, so the program is never outdated. BLOCs also give each center the flexibility to stack them in the order that matches their unique workflow while maintaining the standardization of the discrete data for reporting purposes.

Q: How do you get ASC leaders on board with your software?

TH: Often, I read requests for proposals seeking technology services, and the questions they are asking are IT-driven or request details about specific features and functions. In my experience, much of the final purchase is emotional. At some point, the buyer needs to know that they can trust you and trust your company, and when they do, that's when a sale happens.

When a customer is debating between software vendors, we often give them the contact information for a few of our existing customers so that they can get an honest opinion from their colleagues in the field. We have many customer advocates, and offering a third-party endorsement is an additional, powerful layer of trust that often results in a new client at the end of the process.

Finally, a core mission of healthcare is to help people return to a better quality of life. Most doctors and nurses went into the field they're in because they want to help patients. There are many safety features built into our system, so the EHR functions as both a documentation system and a patient safety enhancement to produce better clinical outcomes. When prospective clients learn about these automated systems and become familiar with how they help benefit their patients, they tend to get on board.

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