EHRs (Expensive. Hideous? Required!)

Resonating across sessions at last week’s 34th ACCC National Oncology Conference: EHR issues. One sentence takeaway: As data collection and reporting requirements multiply, the ideal oncology EHR solution remains elusive.

Here’s a snapshot of what we heard during Friday’s panel discussion on “Strategies for Optimizing Your EHR”: the good, the bad, and, yes, the getting better.

Control, or lack thereof. Sometimes a cancer program or practice has successfully tailored their EHR to meet their operational, programmatic, and reporting needs—only to have the health system or hospital opt for a completely new system.

Interoperability. While Friday’s panel discussion revealed some steps to successful EHR utilization for reporting, panelists also spoke about ongoing challenges, including having to work with several EHRs on a daily basis. “Multiple EHRs require a lot of flexibility, especially for oral medications,” said panelist Linda Frisk, PharmD, Arizona Oncology Associates, PC.

Too many portals. Oncology staff may use three different EHRs on a daily basis, plus some additional portals, for example, for specialty pharmacy. For providers, this can result in “password overload,” commented panelist Rachel Lawlor, MHA, RN, OCN, Cancer Care at Mosaic Life Care.

“Very labor intensive process.” This phrase cropped often during conference sessions–not just during Friday’s panel discussion–usually in reference to ongoing struggles to extract some types of data for reporting. In some instances, at least some data extraction is still a manual effort.

Provider compliance. Although several recent studies point to EHRs and increased “box checking” as contributing to physician burnout, panelists agreed that physician buy-in is critical to optimizing EHR utilization. “You really need to get buy-in from physicians,” said Judy Stone, CMPE,Stamford Hospital.

To get the most from your EHR, “make sure your physicians are filling in queryable fields. Make sure all the data that we can query is in there,” said Linda Frisk, PharmD. One example of leveraging EHRs to improve patient care: the ability to query ‘KRAS’ and have all the progress reports with KRAS come up.

Oncology is different. “It is simply critical to make your IT department aware of what a cancer center does and how very different we are from other divisions of the hospital and other outpatient departments,” said Judy Stone, CMPE. If your IT department doesn’t know what oncology does, invite them to observe for a day or two.

Here to stay. Data collection, analytics, and quality reporting are key requirements as healthcare moves away from fee-for-service into the value-based care environment. “Reporting quickly, efficiently, and in a way you can understand will be critical for our future,” said Linda Frisk, PharmD. EHR optimization should ultimately result in more accessible data to use both operationally and for quality reporting, and demonstrate value. “I think patients want to see value,” she said.

But wait, there’s more.  In conjunction with Friday’s panel discussion ACCC released a new resource, Optimizing Your EHR: Real-World Experiences with Electronic Health Records, which includes practical peer-to-peer tips for getting the most from EHRs to improve patient care, plus strategies to overcome common hurdles and challenges.