How provider data unleashes the value of EHRs

The costly yet necessary investment in an EHR system ought to have yielded equally large returns, but many healthcare organizations never experienced that benefit. However, there’s a better path to unleashing the value of the EHR by connecting it with the digital front door and provider data management solution.

What happened to the return on EHRs?

The average EHR system costs healthcare organizations $15,000 to $70,000 per provider in year one when factoring in the costs of implementation, training, and supporting technology. The figures omit revenue lost during the initial go-live, when providers are lightly scheduled to accommodate a learning curve.

For some hospitals and health systems, nearly $30 billion in federal funds deployed through the HITECH Act for ONCHIT-certified EHRs partially offset costs. But such gains evaporated if the health system changed EHR vendors to:

  • Appease unhappy providers
  • Gain better system functionality or customer service
  • Lower costs over the long term
  • Enable interoperability

Switching vendors makes it more unlikely, for example, that a 1,000-provider system that spent roughly $200 million will recoup the expense of an EHR system. For that system to generate a 30 percent return — or $260 million in savings over five years — it would require recovering $52 million a year. That would be the equivalent of slashing 500 full-time staff. In short, health systems should not look for this kind of quantum-leap technology breakthrough.

Provider data: An avenue of revenue return

While providers master the use of the EHR, consumer-facing and healthcare operations staff use the provider data management platform to manage data — from onboarding and credentialing, enrolling, and monitoring clinicians’ performance, to delivering search and scheduling functionality for patients. Provider data includes not just the people, but the places and services where care is delivered, making it the foundation of the healthcare industry. In fact, all necessary processes on which a health system relies begin with or eventually require provider data. Incomplete or inaccurate information about clinicians hurts the bottom line, negatively affects compliance, and more importantly, interferes with care coordination.

As healthcare becomes increasingly consumer driven, a health system’s ability to gain market share will depend in part on its ability to serve up accurate, consumer-centric provider data that helps patients find the right providers. Think of telemedicine’s meteoric rise during the early part of the COVID-19 pandemic and its ongoing ability to connect patients who need to, or prefer to, stay home yet access providers.

But challenges abound when it comes to efficiently maintaining accurate provider data. Physicians and other clinicians change networks or add services at another site in the same system. They retire, leave, or join new health plans — or in some cases, lose their license. Statistics tell the story of such constant change:

  • In a survey of 700 physicians from the American Medical Association, 52 percent of respondents said their patients experience coverage issues due to payer directory inaccuracies.
  • LexisNexis found that 12 percent of provider locations listed are not current, 15 percent of provider records have phone numbers that are wrong, and 13 percent of provider records are of sanctioned providers.

It’s no surprise that some of the provider data stored in the multiple software solutions that hospitals use to house it is incorrect. A 2021 symplr survey of hospital medical staff offices found one in three medical staff services professionals (25 of 77 responding) reported using four to six solutions for their job, despite the availability of technology that integrates provider data.

A provider directory software solution, therefore, should serve as the single, central hub for all of a health system’s provider data. A unified, scalable solution enables the curation of high-quality provider data and produces profiles that can be shared across the enterprise and to patient-facing sites, in real-time. And when bundling solutions that connect all provider activity — credentialing, privileging, performance improvement, directory, and workforce management (even clinical communications) — health systems achieve value beyond reducing vendor expenses, to include:

  • Reduced readmissions
  • Improved patient outcomes
  • Reduced revenue and resource leakage
  • Increased patient acquisitions

Key functionality in a provider directory software solution includes:

  • The ability to curate data: Health systems require the best data available and putting the power to manage that data into hundreds or thousands of staff hands — crowdsourcing data curation, in effect — is a best practice. For peace of mind, changes to profiles made by staff, and inbound data feeds, should be configurable to be sent to a worklist for further review, to ensure the highest level of data governance and integrity. Collaboration between teams to curate data allows departments across the health system to collectively use better provider data.
  • Real-time provider data updates: Via an integration between the EHR and provider directory software, real-time data updates must be fed to all departments that depend on it. Existing workflows such as EHR, marketing, and claims are optimized as they are continuously supplied with up-to-date and accurate provider data.
  • Scalability: Software platforms must grow with healthcare organizations. For example, the push to value-based care from fee-for-service models continues unabated and demands a provider directory solution that can expand to meet changing needs. Provider data is needed for health plans, accountable care organizations, direct to employers, and other networks. Managing it and preparing for growth requires a solution that can assign providers to multiple networks, assign specialties and subspecialties based on locations, and make updates about availability.
  • Freedom to edit data: A health system’s data is its own, and authorized users require the ability to make changes in-house and see those changes reflected in real time on internal sites, on patient-facing sites, and in other mission critical systems. Incredibly, not all provider directory solutions allow your users to make changes to data without incurring costs. The power to modify data in the moment allows for continuous curation, promises better quality data, and removes the need to contact a vendor, which creates delays and wastes resources.

The role of digital customer intimacy

There’s another avenue of return from the EHR, which has made a timely appearance in this era of increased competition for providers. Provider consolidation and business models that require payers to align with providers, providers to align with employers, and all parties to assume greater risk under healthcare reform means keeping patients in-network via digital customer intimacy is needed. In the simplest terms, adding real-time healthcare provider data to a health system’s digital front door (e.g., a consumer-facing website or a mobile application) can put lost value back into the EHR.

Consumers are hungry for digital healthcare experiences that parallel their experiences in digital retail shopping. They want to search for, find, and book the perfect service seamlessly and in minutes, on their timeline. The stage is set, and the timing is essential, to extend the capabilities of the EHR to meet the expectations of patients through the digital front door.

By exposing real-time provider schedules to patients ready for mobile, online, on-demand scheduling, the provider directory solution — combined with the EHR — can be the missing and final link in achieving the highest levels of patient experience in healthcare. Access to complete, correct, and reliable provider data gives healthcare consumers the ability to search online for a qualified provider who:

  • Has appropriate specialty/subspecialty training and experience
  • Lists helpful reviews
  • Accepts their health plan
  • Is conveniently located and has availability
  • And more

In minutes consumers self-serve by booking an appointment online, assured that it is a perfect patient-provider match. Only the EHR platforms — and third-party software scheduling vendors — can satisfy the availability part.

Job one in the process to create open scheduling is for the CIO to begin the necessary dialogue with physician leaders in both primary care and specialties about the need for open scheduling. One symplr customer that opted to make the leap to open scheduling isn’t looking back after achieving the following results:

  • Six percent of its scheduling is now done online directly by patients.
  • They’ve diverted tens of thousands of calls a month from their call centers.
  • Savings exceed $5 million a year.
  • Providers are happier because they are busier with patient care, not administrative tasks.
  • Concerns over payer mix have proven unfounded.

The next chapter in the story of meeting consumer demand for online appointment scheduling is about better provider data. Provider data management is not the province of EHRs — they are purpose-built patient data platforms. But provider data requires a purpose-built solution — and this is where symplr comes in. Learn more about symplr Directory and all of symplr’s provider data management solutions today.

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