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A new study from Sage Growth Partners has shocking findings about EHRs and value-based care.
The EHR market is maturing, but value-based care needs are not being met, according to a new survey.
The survey, from Sage Growth Partners, found that 70% of providers have had an EHR for at least three years, and 65% are unlikely to replace them in the next three years. However, less than 25% believe their EHRs can deliver on core KLAS criteria for value-based care.
“That’s striking, considering how important value-based care is and will continue to be to the industry,” says Dan D’Orazio, CEO, Sage Growth Partners.
Sixty-four percent of healthcare executives say EHRs have failed to deliver better population health management tools, and a large majority of providers are seeking third-party solutions outside their EHR for value-based care.
Sage Growth Partners conducted an online survey of 100 healthcare executives (87% C-suite) to understand their perspectives about what EHRs can, and can’t, do well to give them what they need in today’s environment. In-depth interviews with six healthcare executives augmented the survey.
“We were heartened to find that over two-thirds of respondents say they are realizing a return on their investments into value-based care. Unfortunately, most of them said they can’t get the capabilities they need from their EHR, so they’re building or buying additional solutions to get, analyze, and use their data to improve health,” says D’Orazio.
“Healthcare providers face tremendous challenges when they try to gain a holistic understanding of their populations and intervene to improve their health,” says Niki Buchanan, business leader, Philips Wellcentive, a provider of population health management software solutions. “Limited data interoperability and visibility into the patients who aren’t coming in for care are major roadblocks. This survey confirms what we hear in the market, which is that most executives are not getting core functionalities such as care coordination, risk stratification, and patient engagement. As they take on more risk, they’ll need those capabilities to remain viable.”
It’s significant that respondents identified a gap between the key proficiencies they need for value-based care and their current satisfaction levels with these capabilities, according to the survey. Quality reporting was the only area where most executives (70%) are satisfied with their existing capabilities. Less than half of respondents are currently satisfied with their abilities in these key value-based care areas: patient engagement, data aggregation, risk stratification, population health analytics, and integration of clinical and financial data.
The report findings are very much in line with the technology challenges Charles Saunders, MD, CEO of Integra Connect, a provider of technologies and services for value-based specialty care, observes practices grappling with as they attempt to transition successfully to value-based care models.
“EHRs were a foundational technology of the fee-for-service era. They focused on automating the documentation around in-office patient encounters and subsequently converting those visits to appropriate billing codes,” says Saunders. “Now, however, payers entering value-based care agreements with practices increasingly hold them accountable for the quality and cost-efficiency of the care they deliver, typically across comorbidities and care settings. Managing patients holistically requires these practices to transform their operations, clinically and financially. As a result, not only do EHRs themselves need to evolve to reflect these new requirements, but practices must embrace an array of new technologies, services and skills with the goal of managing their populations holistically. That’s the source of the disconnect that the report findings so accurately identified.”
The EHR can no longer be the primary focal point of practice technology, according to Saunders. “It remains an important data input, but one among many- including claims, prescriptions, labs, hospital ADT feeds, and more-that support true population health management, coupled with rich analytics and the tools to directly impact quality and cost,” he says.
By contrast, Saunders sees many EHR vendors using messaging that implies they are indeed ‘the’ solution to support practices’ value-based care needs. “However, when you dig deeper, they are typically referring to ability to capture specific data points in their EHRs and then report that out for MIPS or existing Alternative Payment Model (APM) programs. It’s confusing many practices and this was evident in the report findings as well.”
According to Saunders, payers seeking cost and quality improvements in their populations need network providers to be appropriately equipped to manage patients more holistically-which requires a much broader foundation than an EHR alone can provide.
“The good news is that population health management is a core competency of the payer world and executives are well-positioned to collaborate with key providers to help them identify and adopt new skills, technologies, and competencies,” Saunders says. “Managed care execs also bring crucial data to the table, most notably claims, as well as an understanding of proven interventions such as care management that the practices must now adopt.”
Based on the study, D’Orazio has three tips for healthcare executives:
According to Saunders, there are five components that are missing from traditional EHRs that are needed for value-based care success: