From the January/February 2016 issue of HealthCare Business News magazine


Stack says that if necessary, the AMA will see if there are legislative options available to modify the EHR technology to make it more usable. “Right now these tools, which have so much incredible promise to be helpful, are not realizing that promise, and in fact they are interfering with things the way they shouldn’t,” he says.

Alerts when needed
Alarm fatigue is another issue that physicians are running into when using EHRs. A study conducted by the University of Colorado found that one system in the emergency department put out over 123 unnecessary alerts to prevent one adverse drug event. “In my opinion, it is definitely a problem that deserves continued attention because it is the value between safety and productivity,” says GE’s Zimmerman. “Those are the two dynamic forces that say, ‘You’re alerting me on things that I already know.’ “
GE has tuning capabilities so that their customers can adjust parameters for thekinds of alerts that are put out system wide. They can adjust them based on their preferences and the kind of training that they provide to their teams on how to best use the EHR.

Epic also gives their customers the ability to define their own threshold for alarm alerts, but they also provide an analytics engine in the background that targets alerts to the right provider about the right patient at the right time. “We give a lot of guidance to our customers — letting them know which alerts others have found to be particularly useful so they know which ones are the most helpful for providers,” says Dr. Sean McCormick, a physician with the clinical informatics team at Epic.

In the ambulatory environment, NextGen Healthcare allows their customers to set the level of drug-to-drug interaction that they want to view and to minimize the ones that are not significant. “Physicians override drug allergy alerts when it’s really just an intolerance, or the interaction is really not a true allergy to the exact component, but one that is related to the class of drugs,” says Dr. Sarah Corley, chief medical officer at NextGen Healthcare.

Moving to the cloud
Client-server EHR solutions can cost up to $40,000 and that’s causing many smaller and mid-sized hospitals to turn to cloud-based EHRs, according to the Healthcare Data Solutions report. They’re attractive to that segment because they require little to no investment for infrastructure and maintenance, since all that is needed is an Internet connection.

The other benefits of cloud-based EHRs are the ability to access the EHR remotely and the fact that they allow for scalability. GE’s Zimmerman cautions against the use of the term “cloud-based” to mean when somebody in a data center far away is running the same code that the hospital has. To Zimmerman, “cloud-based” means that it is rewritten for a cloud operating environment like Microsoft Cloud or IBM cloud computing.

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