Read this if you are a CEO, CFO, COO, CIO, or board member of a hospital or health system.
There was an era in the early 2000s (that coincided with the introduction of Meaningful Use) when the term electronic health record (EHR) had a distinct meaning and scope. At that time, when we spoke about EHRs, we were referring to the replacement of paper charts with an automated electronic system.
The industry was using the term EHR in an era when a “best-of-breed” software strategy was prevalent and health systems had different EHRs in their inpatient units, clinics, emergency departments, and senior living communities. The scope of EHR projects in this era was smaller and more incremental in change. For example, an ambulatory EHR project may have only been adding clinical components to the existing registration, scheduling, and billing modules. The changes were small, incremental, and manageable.
Today’s EHR projects
Fast forward to today and while both the meaning and scope of the EHR have shifted, we still use the same terminology. Now, when we talk about EHR projects, we mean replacement of the majority of the current software vendors a health system may have with an integrated solution from a single vendor (or a couple of vendors). We are talking about clinical, ancillary, financial, and operational departments, in addition to single problem lists, integrated charge description masters, and one patient portals. Here is an example of the scope of what an EHR project can include today:
- Clinical modules, including areas such as pharmacy, primary care, acute care, physical therapy, and emergency medicine
- Financial modules, including claims, payment processing and posting, denial management, and A/R follow-up and appeals
- Ancillary modules, including mammography, radiology, and laboratory information systems
- Operational and reporting modules, including analytics, quality metrics, and surveillance of high-risk patients
- Population health and interoperability, including patient registries, case management solutions, and connections with post-acute care settings and community care providers
- Technical modules, including integrated faxing, interfaces, and cloud-based services
- Human capital management modules, including recruiting, training, payroll, and performance management
- Supply chain modules, including perpetual inventory and real-time supply charging
- Patient engagement modules, including patient portals, self-service tools, and integration with home medical devices
- Specialty modules, including labor and delivery, anesthesia, oncology, and behavioral health
So, as you can see, the scope of the modern-day EHR is massive, yet we still use the same term, which may be doing a disservice to organizations by not illustrating the significant scope of modern-day EHR transformations. Hospital boards and senior leadership teams thinking of EHR projects with 2000s expectations only to face the challenge of a 2024 EHR scope during implementation may face the harsh realities of increased stress, the potential of staff turnover, and more challenging projects.
New name for a new era
It may be time to move beyond the term EHR to one that better reflects the scope of the projects we are working with today. So, what should that term be? Hospital Information Systems (HIS) has a broader scope but feels dated and not very descriptive. Enterprise Resource Planning (ERP) has a large scope and meaning in other industries, such as manufacturing, but is really a subcomponent (GL, AP, etc.) of the system we are trying to name. So, what might be better? Here are some ideas:
- Digital Healthcare Platform (DHP) This has some appeal as it incorporates the ideas of digital healthcare and an overall platform. We could see this helping leaders understand the full scope of these projects better with this term.
- Enterprise Healthcare Platform (EHP)
Replacing digital (above) with enterprise to help elevate the overall scope has some merits.
- Electronic Healthcare Delivery System (EHDS)
Starting with a familiar sound to EHR with 'electronic healthcare' followed by a broader ending of 'delivery system' allows people to see it as a broader version of a familiar term.
- Healthcare Resource Planning (HRP)
Taking a page from the manufacturing space with their ERP and Manufacturing Resource Planning (MRP) systems and creating a Healthcare Resource Planning term. Feels familiar and easy to say in a sentence, such as “Are your HRP and ERP systems optimized?”
- Electronic Healthcare Community Platform (EHCP)
Similar to the suggestion of EHDS (above), but with a broader concept of community. This helps people think about larger-scale goals such as population health.
Of course, a new term won’t be settled by this article. Our goal is to start a conversation about changing our understanding and possibly our language to better reflect the scope of these projects. We want boards and senior leaders to understand the amount of change—and potential disruption—that occurs when they take on these projects. If your leaders can have a greater understanding of what is coming in advance, they will likely have a better chance of project success.
We may begin using Enterprise Healthcare Platform and see if sticks, but we welcome reactions to this article and suggestions on a new and better term. If you have questions about this next evolution of EHR naming or your particular situation, please don’t hesitate to contact us. We’re here to help.