Healthcare is the largest industry in our economy, yet it is the last to migrate into the “digital or electronic” age. Healthcare has been last to the party largely because of the incredible amount of fragmentation within the industry. Additionally, the best of breed attitude regarding testing, diagnosis and treatment has resulted in the development of unique systems, equipment and protocols that were never designed to feed into a single or “connected” database.
Many factors are helping to fuel this change, but certainly the biggest factor is the federal government incentives for physicians to implement EHRs in their practices. Over 500 unique EHR vendors are participating in the biggest land grab that the industry has ever seen! While integrating one laboratory information system to one EHR may not present significant challenges, integrating 40 to 50 different laboratory and registration systems to over 500 different EHRs could tax any IT department. To add to the chaos, the hospitals and labs cannot predict or control the demand they will have from a quantity standpoint or from which EHRs.
Most businesses will evaluate their core competencies and decide which functions should be outsourced as opposed to keeping in house. For example, a law firm will probably outsource their printing, but keep their firms legal work in house. Healthcare facilities have been slow to subcontract anything due to the implications and potential effect it might have on patient care. As every piece of medical equipment now provides a digital record, how will facilities react? Should healthcare facilities farm out some of their information technology demands or should they staff up to meet the current peak demands they are experiencing?
Here are some reasons to outsource EHR connectivity:
- Reduced cost from direct labor as well as general and administrative expenses
- Move staff to more critical/unique tasks, providing flexibility
- Allows for erratic demand; do not have to staff for peaks
- Reduce start/completion time for projects
Outsourcing EHR connectivity is a lower cost alternative than keeping the function in house. Hundreds of facilities across the country have conducted an ROI analysis and determined that subcontracting is the more cost effective path to take. While the argument can be made that if current staff is under-utilized, performing this function in house would not add any incremental cost, few if any healthcare facilities find themselves in this position. Additionally, efficiencies exist when utilizing a team that has a successful track record to complete EHR connectivity projects because that is what they do “all day, every day!”
With all the demands that IT departments have to integrate equipment or systems within the four walls of the facility, by outsourcing EHR connectivity, options exist to be more responsive to those demands. Typically most facilities will put EHR connectivity at the bottom of the priority list, which can have a significant negative impact to growing/maintaining an outreach program.
As external physician groups sift through the 500 EMR vendors to find the right one, they generally do so without consulting their lab providers as to which one they chose or the timing for implementation. Most lab providers find out only when the EHR has been installed and they receive a call from the practice saying, “connect us.” Staffing for the peak is not cost effective and alternatively making the client wait until time is available usually results in a lost business opportunity.
It is very difficult, if not impossible, for an in-house staff to compete with a third-party provider regarding project completion. Constantly being pulled away for “higher priority” projects that will always be more interesting to the internal team can mean that the completion of EHR projects could drag on for several months, when in fact could be completed in a few weeks.
Why then is subcontracting such a huge hurdle for many organizations? Although there are very good reasons to subcontract, many administrations appear to want to internalize EHR connectivity for non-financial reasons that in some cases maybe emotional or “fear based” in nature. Because healthcare facilities are not traditional outsourced, they usually dismiss the notion without giving it a fair evaluation. IT departments, in particular do not want to give up the opportunity to increase their influence and or increase staff, and initially resist outsourcing.
Many in house staffs will embrace the idea of expanding their influence outside the walls of their facility and the challenges that new EHR connectivity projects can offer. What happens next is that they become embroiled in the “perfect storm” of ambulatory physician practices, the myriad of EHR vendors with their various capabilities, and their own clinical or business development staff. IT staffs quickly become disinterested in the repetitive nature of the process to electronically connect their clients, as well as meeting the objectives of all the different stakeholders. IT departments are usually not geared to be able to successfully meet all the challenges that these groups can present. Deadlines are missed, existing or potential clients are lost, and confidence in the internal staff to get things done suffers.
While outsourcing may not be the perfect answer for all, it clearly should be given greater consideration to meet the incredible demands that healthcare facilities will face over the next five years. At a minimum, it could be utilized as a backup strategy to augment internal staff and allow the facility to concentrate on its core competency of delivering the best in patient care. As their trust with the third-party provider grows, and emotion is taken out of the equation, it just might become a critical part of your “connected” strategy.