Service Documentation Monthly Source: The Academy of Healthcare Revenue
Hybrid Hospitals: A Transition to Electronic Health Records
Much attention in recent years has been placed on
hospitals’ adoption of EHRs and the continued transition
from paper to electronic records. In many
instances, providers frequently stop midway
through the transition process, choosing to use
both paper and electronic records. However, if
hospitals do not fully complete the transition from
paper to electronic records, providers may never
realize the full potential of EHRs and the positive
effects they can have on staff members’ processes
and hospitals’ financial health.
Though EHR implementation has received extensive
coverage, a recent study showed that implementation
projects are often only partially completed.
According to the study, more than 85 percent of
hospitals operate in a hybrid environment and more
than 50 percent of records eventually return to
paper form. Also, more than 96 percent have at least some patient information on paper, and more
than 34 percent combine paper, images, and electronic
documentation.1 Additional research found
that many providers plan on fully implementing
EHRs, but their top concerns were internal security
breaches, lack of financial support, and lack of
hospital staff and management support, making full
commitment to the project improbable.2
Despite these findings, the future for EHR implementation
is believed to be a bright one. Experts
project that the EHR market could grow by 13.5
percent in the next four years, and this market
could reach $4.85 billion by 2015.3 This is strong
evidence that hospitals, despite their concerns,
consider EHRs a key strategy in improving their
care and enhancing revenue cycle processes, and,
as the graph below shows, many are at least
beginning the process of EHR implementation.
However, full, not partial, implementation of EHRs
is necessary in order for providers to realize the
potential efficiency gains these systems offer.
Hospitals existing in a hybrid environment of
both paper and electronic documents may be
missing out on the full benefits of these systems. In
many hybrid environments, it is a question of reconciling
traditional processes with new, electronic
ones. Many staff members are more familiar with
paper records and others believe the transition
to electronic records will require too much time
and effort.4 Nevertheless, full EHR adoption can have an important impact on staff members’
processes.
Some research shows that hybrid environments
are a good starting point for EHR adoption, without
which, EHR adoption could fail. At this initial stage,
staff members can take advantage of more efficiency
in retrieving and storing records and more
time to obtain and code crucial patient information.
This is also an opportune time to begin education
and training so that staff members understand their
responsibilities and are prepared to complete their
duties.5
Once the initial hybrid foundation has been
established, providers must continue to progress
toward full EHR adoption, which can show even
more significant staff process enhancements once
implementation is complete. With all records available
electronically, coders can more easily track
and identify instances where documentation is
incorrect and insufficient and be able to communicate
with clinicians or clinical liaisons to fix potential
breakdowns and code more effectively. Time
can be spent on evaluating and coding crucial
patient information for hospital reimbursement, not
on locating and obtaining part or all of patients’
records, as coders can simultaneously and immediately
access patients’ information.6
As hospitals continue to make the transition to
electronic records, more providers will need to
ensure hospitals are doing all that they can to complete
the transition process to enhance staff members’
documentation and workflow. Providers that
continue to optimize their revenue cycle processes
by utilizing the full capabilities that EHRs offer will
be more likely to achieve a positive return on their
investment through enhanced staff productivity
and other efficiency gains.
1 Beth Walsh, “Survey Shows Paper Prevails,” ADVANCE for Health
Information Professionals, 29 January 2007.
2 “18th Annual 2007 HIMSS Leadership Survey,” Health Information and
Management Systems Society, 10 April 2007.
3 Deborah Pappas, “Rapid Adoption of EHRs and RHIOs,” ADVANCE for Health
Information Professionals, 17 July 2007.
4 Walsh, “Paper Prevails.”
5 Selena Chavis, “HIM’s Finest Blend,” For The Record, 11 December 2006.
6 Carlton Cottrell, “Swinging for a More Perfect Approach to Coding,” For the
Record, 5 February 2007.
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Media Contact Andrea Morrill
Research Director
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