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Clinical Optimization Effort and ROI Matrix

Posted on September 6, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Over on Hospital EMR and EHR, Galen Healthcare Solutions has been providing some really practical and detailed information on optimizing an EHR as part of their EMR Clinical Optimization Series and they’re just getting started. Along with the EMR Optimization blog posts, they also have published a FREE EMR optimization whitepaper that dives into tips, tricks, and perspectives on how to approach driving a tangible return on your EMR investment.

I love that we are finally moving past the discussion of EMR implementation and moving towards EMR optimization. As David Chou, CIO at Children’s Mercy Kansas City, recently said in the CXO Scene podcast, “Hospitals have invested at minimum $100 million on their EHR and that doesn’t include all the consulting and training services required to implement the EHR on top of it.” Given this massive investment, it is more than time to optimize our EHR implementations and ensure we’re getting a great ROI from the investment.

In Galen’s EMR Optimization Whitepaper, they shared this really impressive matrix that looks at the clinical optimization effort required against the benefits an organization will receive from those efforts:


(Click on the above image to see the large version of the matrix)

There’s a lot to chew on in this matrix, so feel free to spend some time looking over the details. In fact, it would be beneficial to do a deep analysis of this matrix with your organization. No doubt you’ll uncover ways that your organization can benefit from better clinical optimization and it will help you evaluate areas where you should focus your initial attention.

While there’s a lot of detail in this matrix, I was struck by how few levers had an impact on costs. This is a tremendous insight to consider when it comes to EHR and clinical optimization and their impact on healthcare costs. No doubt there are other more important drivers of cost that need to be considered.

On the other hand, I was also struck by how many of the opportunities in the matrix were able to directly maximize revenue while also improving quality. Sometimes I think we look at the care we provide and see our efforts to improve quality as counter to our efforts to maximize revenue. This chart clearly illustrates how you can focus on improving the quality of care your patients receive while still maximizing your organization’s revenue.

I also like to look at the outliers in these matrices. In the matrix above, they’re found in the middle of the matrix. They require less effort, but the monetary ROI is high. I’m talking about “Keeping Patient in Network” and “Driving care delivery and managing acute and chronic diseases by evaluating the patient’s problem list in clinical documentation.” These are both things that can be done much more effectively on the back of the data found in the EHR. Are you maximizing these opportunities? I know many organizations that have barely begun the work of reducing volume leakage and improved clinical decision support. Those might be great places for your organization to start in your EMR optimization efforts.

What stands out to you when you look at the EMR optimization matrix above? Would you change any of the values in the matrix? Are there areas that are missing from the matrix that you would add? How many of these optimization efforts are you working on in your organization? We look forward to hearing your thoughts and perspectives in the comments and on social media.

Note: Galen Healthcare Solutions is a sponsor of Healthcare Scene and the EMR Clinical Optimization Series of blog posts.

EHR Optimization – #HITsm Chat Topic

Posted on June 27, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 6/30 at Noon ET (9 AM PT). This week’s chat will be hosted by Justin Campbell (@tjustincampbell) and Julie Champagne (@JulieEChampagne) from @GalenHealthcare on the topic of “EHR Optimization.”


Healthcare information technology witnessed a wave of implementation, where the promise of efficiency gains and meaningful use incentives drove adoption of Electronic Health Records. As most Healthcare Delivery Organizations (HDOs) now have an EHR in place, it’s becoming clear that the traditional arguments for EHR implementation are insufficient to maximize return on technology investments.  As EHR adoption approaches maximum levels, HDOs are refining EHR strategy from a short-term clinical documentation data repository to a long-term asset with substantial functionality surrounding clinical decision support, health maintenance planning and quality reporting. In fact, according to a recent survey conducted by KPMG, in collaboration with CHIME, 38% of the 112 respondents ranked EMR/EHR optimization as their top choice for where they plan the majority of capital investment over the next three years.

Further, as the capabilities and sophistication of EHRs continue to grow, there is a widening divide between healthcare organizations that harness the capabilities for a competitive advantage and those that are crippled by poor usability, workflows and adoption. Capturing information is only the most basic feature of an EHR. HDOs should ensure the EHR is positioned to be flexible and extensible to adopt emerging technologies driving insight to the point of care. Thus, tremendous opportunity exists for EMR clinically and operationally oriented optimization to generate additional margin, ease the burden on providers, and improve care HDOs must refine their EHR strategy. In this tweetchat, we’ll weigh EHR optimization against replacement, discuss EHR optimization opportunities and barriers, and consider EHR optimization levers, effort, KPIs, and ROI.

Resources and Other EHR Optimization Reading:

  1. EHR Optimization Whitepaper
  2. EHR Optimization Infographic
  3. EHR Clinical Optimization Toolkit
  4. Achieving Clinical System ROI Through EHR Optimization, Replacement & Portfolio Rationalization
  5. Healthcare CIOs Focus On Optimizing EMRs
  6. Has Electronic Health Record Replacement Failed?
  7. EHR Implementation Accomplished – What’s Next?

Please join us for this week’s #HITsm chat focused on EHR Optimization. We’ll use the following 6 questions as the framework for the discussion:

This Week’s Topics
T1: How did the big-bang implementation approaches contribute to EMR inefficiencies and what can be done to mitigate? #HITsm

T2: What is it about current EMR technology that contributes directly to physician inefficiency? #HITsm

T3: How do you get providers engaged in an optimization initiative if they are disenchanted with the product and suffering from burnout? #HITsm

T4: How can clinical workflows be adjusted to improve physician-patient interactions by removing EHR technology and data entry as an obstacle to F2F interaction? #HITsm

T5: What are the most common barriers to EHR optimization and how are they overcome? #HITsm

Bonus: What amount (if any) of ROI should HDOs expect from EHR optimization and is it worth the effort? #HITsm

Upcoming #HITsm Chat Schedule
7/7 – International EHR Adoption: Challenges and Solutions
Hosted by Stefan Buttigieg, MD (@stefanbuttigieg)

7/14 – TBD
Hosted by TBD

7/21 – Meeting the Patient Where They Are
Hosted by Melody Smith Jones (@MelSmithJones) from HYP3R

7/28 – How Does Age Impact Patient Satisfaction & Provider Switching?
Hosted by Lea Chatham (@leachatham) from @SolutionReach

8/4 – TBD
Hosted by Alan Portela (@AlanWPortela) from Airstrip

We look forward to learning from the #HITsm community! As always let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Healthcare CIOs Focus On Optimizing EMRs

Posted on March 30, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she’s served as editor in chief of several healthcare B2B sites.

Few technical managers struggle with more competing priorities than healthcare CIOs. But according to a recent survey, they’re pretty clear what they have to accomplish over the next few years, and optimizing EMRs has leapt to the top of the to-do list.

The survey, which was conducted by consulting firm KPMG in collaboration with CHIME, found that 38 percent of CHIME members surveyed saw EMR optimization as their #1 priority for capital investment over the next three years.  To gather results, KPMG surveyed 122 CHIME members about their IT investment plans.

In addition to EMR optimization, top investment priorities identified by the respondents included accountable care/population health technology (21 percent), consumer/clinical and operational analytics (16 percent), virtual/telehealth technology enhancements (13 percent), revenue cycle systems/replacement (7 percent) and ERP systems/replacement (6 percent).

Meanwhile, respondents said that improving business and clinical processes was their biggest challenge, followed by improving operating efficiency and providing business intelligence and analytics.

It looks like at least some of the CIOs might have the money to invest, as well. Thirty-six percent said they expected to see an increase in their operating budget over the next two years, and 18 percent of respondents reported that they expect higher spending over the next 12 months. On the other hand, 63 percent of respondents said that spending was likely to be flat over the next 12 months and 44 percent over the next two years. So we have to assume that they’ll have a harder time meeting their goals.

When it came to infrastructure, about one-quarter of respondents said that their organizations were implementing or investing in cloud computing-related technology, including servers, storage and data centers, while 18 percent were spending on ERP solutions. In addition, 10 percent of respondents planned to implement cloud-based EMRs, 10 percent enterprise systems, and 8 percent disaster recovery.

The respondents cited data loss/privacy, poorly-optimized applications and integration with existing architecture as their biggest challenges and concerns when it came to leveraging the cloud.

What’s interesting about this data is that none of the respondents mentioned improved security as a priority for their organization, despite the many vulnerabilities healthcare organizations have faced in recent times.  Their responses are especially curious given that a survey published only a few months ago put security at the top of CIOs’ list of business goals for near future.

The study, which was sponsored by clinical communications vendor Spok, surveyed more than 100 CIOs who were CHIME members  — in other words, the same population the KPMG research tapped. The survey found that 81 percent of respondents named strengthening data security as their top business goal for the next 18 months.

Of course, people tend to respond to surveys in the manner prescribed by the questions, and the Spok questions were presumably worded differently than the KPMG questions. Nonetheless, it’s surprising to me that data security concerns didn’t emerge in the KPMG research. Bottom line, if CIOs aren’t thinking about security alongside their other priorities, it could be a problem.

“Blended” Super User Team

Posted on December 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At a conference I attended this Fall, I heard one person describe the “blended” super user team that they used during their EHR implementation. This is such a valuable idea for any EHR implementation. Having each areas input can really improve your probability for success. The various viewpoints will help you avoid major issues that could hijack or derail completely your EHR implementation.

The key thing you have to do with a blended super user team is to make sure you don’t demean the feedback, comments, and suggestions of anyone on the team. If you demean or belittle many of the people mentioned (technical, front desk, HIM, nurses, etc), then they’ll shut down and end up being a thorn in the side of your EHR implementation as opposed to a support. However, if you thoughtfully listen to, consider, and appreciate the feedback from all of these people, then you’ll be able to benefit from their ongoing support and insights in the process. I’ve seen both things happen and it’s not pretty for anyone when the staff feel alienated. It can get really ugly.

It turns out these “blended” super user teams are also what you need to optimize your EHR implementation as well. Sometimes that can be the same people that were part of the EHR implementation super team, but you also want to integrate other voices to the conversation as well.

Many doctors love to just pour as much work as possible on their staff. Indeed, you want to have everyone in your organization working to the highest level of their license. You also want to make sure you’re utilizing your most expensive resource (usually the doctor) in the most effective way possible. However, if you only focus on optimizing the doctors time and not the rest of the staff, that will eventually catch up with you. Once it catches up with you, the doctor will be doing work they don’t want to do, the other staff will feel overworked and no one will be happy.

You have to optimize the entire EHR spectrum to get the most value out of your EHR investment.