Measuring User Adoption, KPIs Key for EHR Integration Across M&As

Healthcare organizations are no longer shopping for their first EHRs; but in an industry characterized by healthcare mergers and acquisitions (M&As), the question of EHR integration across previously disparate organizations looms large.

As of 2021, 96 percent of non-federal acute care hospitals have adopted a certified EHR. With an increasing level of healthcare merger and acquisition (M&A) activity over the past decade, what happens when those M&As leave a health system using numerous different EHRs and revenue cycle management (RCM) platforms?

Take LCMC Health, for example. After a series of M&As, the New Orleans-based health system included four independent hospitals on different technology platforms, including one still on paper.

Tanya Townsend, MSMI, CHCIO, CDH-E, came on board as CIO in 2014 to help bring disparate clinical and RCM systems together under one roof through an integrated EHR implementation.

"Our main priorities for the system were its integration capabilities across clinical, operations, and revenue cycle functionality," Townsend told EHRIntelligence in an interview.  

She said that since LCMC’s hospitals had already established relationships with several top EHR vendors, it didn’t take long for the health system to decide on a platform.

“It was primarily myself and the CEO that really drove the decision and ultimately our board," Townsend said.

The health system wanted to ensure the platform supported a longitudinal patient record so that providers could access complete health histories regardless of what LCMC setting a patient visits.

Additionally, LCMC wanted to pare down its technology investments by leveraging a system that included RCM.

"We wanted to cover as much ground as we could for all of the different modalities that we have, whether that be revenue cycle or ancillary services such as lab and imaging or emergency, to even the outpatient side," she explained. "It is helpful from an operations excellence standpoint to have that fully integrated record, including revenue cycle."

"Of course, there is a cost to doing these things, so that was part of the assessment as well," Townsend acknowledged.

While the integrated Epic EHR was a major investment, she noted that it has saved the health system money in the long run by deduplication of systems.

"When you're a disparate environment, there's a cost to all of those various tools, so it was a huge savings when we took out the duplication of expense,” Townsend said. “With an integrated solution, if you leverage it to its full capability, you're not purchasing other solutions and trying to piece those together."

However, she recommended that health systems carefully assess their costs upfront.  

"Healthcare is very complex," she said. "We have hundreds of systems that may need to be integrated with the electronic health record, so don't forget about those that need to be assessed. It's a big commitment on all levels of the organization, not just during the implementation, but also understanding what that resource commitment needs to look like in the long-term.”

Townsend also encouraged other health systems to focus on measuring user adoption and other KPIs periodically upon implementing an integrated EHR.

"Get your baselines in terms of what your performance is today, and then start measuring and setting goals of what we're trying to accomplish both during the implementation and afterward," she said. "It's not just a one-time measure where you check it off the list and move on."

The Healthcare Information and Management Systems Society (HIMMS) EHR adoption model, which Townsend referred to as an industry benchmarking tool, has helped LCMC measure end-user adoption and other key performance indicators (KPIs). 

"It's not just about the technology or turning on a specific feature in the system," Townsend emphasized. "It's helping to measure how well we're using the system."

"Go-live is only the beginning,” she said. “The electronic health record is a very powerful tool not just to take care of our patients, but also find those operational efficiencies and marry the goals of quality, safety, patient experience, and clinician satisfaction.” 

Six of LCMC's nine hospitals have fully implemented the EHR.

"It seems like every year we're doing another hospital acquisition merger, so we're constantly doing rollouts," Townsend said.

LCMC’s most recent acquisition was in January 2023. The hospital will be integrated into the EHR over the next 15 months.