An EHR is a massive investment of human and financial capital. Five hospitals that spent the most in 2023 paid a combined $392 Million to install EHRs.1 Total EHR spending is forecast to reach $19.9 billion in 20242.
A significant part of any investment is adapting the EHR to the particular health system’s infrastructure and workflows. Incremental solutions that disrupt a critical workflow are a non-starter. Any technology aimed at helping healthcare professionals must enhance the EHR, which is the nerve center of clinical and administrative operations.
As evidenced by the historical and projected growth in EHR expenditures, healthcare providers have invested billions and countless hours in them, encouraged by federal policies and regulations. However, realizing a real return on their investment remains a challenge.2
Revenue cycle leaders who need to justify investing in tools to improve productivity and achieve revenue goals must position solutions as complementary to and supporting the EHR’s objectives. For the clinic, this means improving patient experience and achieving better outcomes. Revenue cycle workers ultimately see EHRs as tools for maximizing revenue by improving billing accuracy, reducing claim denials, and accelerating reimbursement cycles.
Ironically, most EHRs started as billing systems and then added on clinical workflows, so they should be much better at optimizing revenue capture and minimizing administrative burdens. However, there are issues with EHRs that still impede efficiency and productivity. Here are three common complaints:
- Complexity and Usability. One of the top complaints is the complexity of EHR systems and the lack of user-friendliness. Many EHRs focus on clinical documentation rather than billing and revenue cycle management workflows. As a result, revenue cycle workers may struggle with cumbersome interfaces, unintuitive navigation, and excessive clicks required to complete billing tasks. This complexity can lead to frustration and inefficiency, as workers spend more time navigating the EHR system than focusing on revenue-generating activities.
- Customization and Flexibility. Another common complaint is the limited customization and flexibility of EHR systems to accommodate the unique needs of revenue cycle workflows. Revenue cycle workers often require specific features and functionalities tailored to billing, coding, and reimbursement processes. However, many EHRs offer limited customization options, making it challenging to adapt the system to meet the evolving needs of revenue cycle operations. This lack of flexibility can hinder productivity and prevent revenue cycle workers from optimizing their workflows effectively.
- Integration and Interoperability Issues. Integration and interoperability issues between EHR systems and other healthcare software solutions are significant pain points for revenue cycle workers. Inefficient data exchange between EHRs and revenue cycle management (RCM) systems can lead to claims processing delays, billing errors, and revenue leakage. Revenue cycle workers may also encounter challenges when accessing patient information from external sources, such as insurance eligibility verification and electronic remittance advice (ERA). These integration issues disrupt workflow continuity and contribute to revenue cycle inefficiencies.
AI addresses challenges and has great potential to make workers more productive and engaged.
An AI solution that prioritizes revenue cycle workers’ needs and improves usability, flexibility, and interoperability with other systems will help them navigate EHR challenges more effectively and enhance their overall experience with the system.
- Efficiency Enhancer
AI and automation can simplify existing workflows and free high-value workers from old, inefficient workflows. Subject matter experts can leverage their knowledge in more efficient ways. They get faster access to data and timely documentation, which helps reduce errors and boost productivity. - Cost Reducer
AI and automation can make claim statusing a breeze. Payer portals account for a significant increase in administrative costs and can change without notice. Navigating portals to file claims and check status has become a time-and-money hole. Giving workers fast and timely access to portals from within the EHR saves time and money. - Revenue Maximizer
Improving billing accuracy, reducing claim denials, and accelerating reimbursement cycles are all achievable with the proper AI intervention that integrates with existing EHR workflows and requires less work, not more.
The EHR is here to stay and will continue to be essential and challenging for healthcare workers. Leaders need incremental solutions that align with organizational objectives and integrate with their EHR systems and workflows to extend the value of this massive investment of people and money.
Janus has solutions that do this and more. Let’s talk.
Read the rest of our AI blog series:
- Article 1: Demystifying AI terminology
- Article 2: Why the revenue cycle is the ideal proving ground for AI in healthcare
- Article 4: AI elevates the revenue cycle worker
1 Becker’s Health IT, November 21st, 2023
2 It’s Time to Expect More From EHRs, Medical Economics, Holly Urban, July 2023
