As health systems look to automate as much as possible to reduce administrative burden, Lisa Bragg, R.N., B.S.N., a managing director at consulting firm Impact Advisors, spoke with Healthcare Innovation about the idea of doing an EHR “tune-up,” which she described as evaluating and optimizing existing EHR systems to improve efficiency and reduce manual workarounds.

Impact Advisors works with health systems on EHR implementations, post-implementation optimization, and major system migrations, ensuring seamless integration and operational efficiency. They also help clients with EHR vendor evaluations and transitions.

Bragg, who has experience as a critical care nurse, said health system clients today are asking for help with three main things when it comes to automation, The first is with ambient listening and documentation, smart rooms that are voice-enabled, and virtual care. They want help evaluating what is purposeful, meaningful and safe, Bragg said. “There's a lot of noise in the industry about AI, and they're not really sure where to go,” she said, adding that they want help in deciding what to prioritize. “Once they implement and adopt AI, if they're not getting the benefit they expected, we partner with them to try to find out why — and a lot of times it's the integration of this technology. Your practice and performance have to improve to align with it. And we close that gap between how you use the technology and how that folds into that daily workflow of the end user.”

A lot of times, if the health system is using a third-party vendor, they begin with a return on investment that they're hoping to get, but then if they're not achieving that, Impact Advisors is brought in to help them get to that point. “When you're thinking about adding technology or augmenting your team, we need to make sure the regular processes are working,” Bragg noted. “Otherwise the technology just sits on top of something that's not working, and you're automating a process that doesn't work.”

Bragg suggests health systems consider doing something called an EHR tune-up.

The pressure to do these EHR tune-ups can come from the recognition that the health system is not achieving the goals it expected. For instance, they are still having a length-of-stay issue, even though they implemented a patient throughput solution two years ago. Forward-thinking organizations want to do better, Bragg said. “Clients ask us to take a look at how we're using applications or the EHR or their workflow or processes.”

Impact Advisors also helps health systems that are deciding to switch EHR vendors if they have a legacy system, and it also helps during the transition to a new EHR. “We don’t make that decision for them, but we are helping them take that journey,” Bragg said. This work also happens when health systems go through a merger or acquisition and they want to unify on a single EHR platform. Bragg said the firm is currently working with an 11-hospital health system as they transition to a new EHR. 

After implementation, Impact Advisors may be asked to stay on for the optimization phase. “It’s really challenging to try to optimize as you go in, because during the implementation there are a lot of moving pieces,” she said.