Leadership buy-in, staffing changes key in an electronic health system

Transitioning to an electronic health system comes with its challenges, from learning new software systems to updating staff roles. Understanding the resources your facility has available is critical to adapting to these changes.   

“You staff a hard copy office differently than you staff an electronic office,” says James Dunnick, MD, FACC, CHCQM, CPC, CMDP, physician and consultant at The Dunnick Group LLC. in New Orleans.

Getting the backing of the hospital executive leaders is key to implementing changes. To increase the chances of your proposed change to software or staffing being accepted, explain the need. When the C-Suite understands the reason behind the change, they become active leaders in the solution. “First explain the problem, and then be part of the solution,” advises Dunnick.

Getting your chief financial officer (CFO) or chief operating officer (COO) to understand the need for change is often about shifting his or her perspective. CFOs and COOs have a view from above and see a bottom line. They often feel that audit losses are a normal part of doing business. “However, hospital administrators do not have to accept certain losses as normal operating expenses,” says Dunnick. “Audit losses from documentation errors can be lessened significantly with provider education.”

Office staffing can also present challenges. Although it may appear that you’d need less full-time employees when operating in a more electronic environment, this isn’t necessarily true, says Dunnick.

Some areas may require additional staffing whereas others can remain the same or require fewer staff members to be fully operational. Facilities may also decide to update job descriptions, ramping up the responsibilities of current staff members. While this can be a successful solution, it requires your employees to have or acquire new skills. “Understand that the patient flow needs a different process in an electronic office compared with a paperwork office. Recognize your bottlenecks and provide employee training where needed,” says Dunnick.

Be aware that software may be complicating communication across departments and facilities. Dunnick points out that in any given community, the hospital and various physician groups may all be using a different EHR. The inability of one EHR system to communicate directly with another can create complications. “The provider may not be able to directly send office records to the hospital or office records to another provider,” says Dunnick. “They must be faxed and this leads to a hybrid chart—a chart that is part electronic and part hard copy.”

This list of EHR options grows with time. “Until these systems are made compatible, the hybrid chart must be recognized as a potential error source and solutions placed to solve these issues,” says Dunnick. This will help you standardize the process across your health system.

As compliance becomes more complex with greater payer scrutiny, hospitals and providers will be facing the economic impact. One solution is to make provider compliance education available, recognize the importance of the compliance department, and practice the new patient documentation techniques that are learned, advises Dunnick.

Understanding the problems of compliance and documentation, and then implementing a plan for education can lead to greater efficiency. Strengthening your compliance documentation improvement program will reduce audit losses, improve quality metrics, and increase patient access. This may be a continuous challenge for all as facilities as they shift to an electronically-based health system.