Achieving Clinical Benefits Realization – Start with the Basics

Clearly, Electronic Health Records (EHRs) as technology enablers hold great promise for improving efficiency and quality. In spite of that, a majority of health systems that have implemented EHRs in the past decade have failed to achieve the expected return on investment. There are a variety of reasons for this, but most boil down to health systems not having a clear understanding of what the benefits are and what is required to achieve those benefits.

Being successful in EHR benefits realization requires a firm understanding of several fundamental principles:

• Benefits are net positive changes in outcomes – A benefits realization program should aim to deliver a number of outcomes identified as being beneficial to the organization. Ideally, these benefits are aligned with the health system’s strategic plan. Impact Advisors’ definition of clinical optimization is “outcomes based improvement to meet a defined set of objectives.” Clinical optimization is required to achieve desired improvements or outcomes and outcomes are required to achieve benefits.
• Benefits do not just happen – Benefits realization is beyond project management. It requires active monitoring of the delivery of projects, the effectiveness of change and the achievement of outcomes. Benefits do not automatically appear when a new technology is implemented. IT is an enabler for operational or business benefits. EHR implementation by itself is insufficient to deliver business benefits. Technology enables positive changes to the way people work. It is those positive changes that ultimately lead to benefits realization.
• Benefits realization requires executive support – In order to achieve benefits, executives must fully support the benefits realization program and give benefit owners both the authority and accountability to achieve results. A corollary to this is that benefits processes must be linked with program governance.
• Benefits from technology happen over the long term – Benefits are achieved over a long period of time as people learn to use new technology and health systems integrate it into business processes. The benefits lifecycle extends past traditional project lifecycles like EHR implementation, often for an extended period, and must be managed as such.
• Benefits realization is a continuous process – Benefits realization does have a defined start, but it doesn’t have a defined stop. It is a continuous process of envisioning outcomes, identifying key determinants of those outcomes, defining a path to achieve the outcomes, implementing, checking results and making dynamic adjustments to ultimately achieve the desired operational outcomes.
• Benefits require change – Benefits cannot be delivered without change. It may require change in the processes people use to complete tasks, change in the tools used to support those processes, change in communication or a host of other changes. Perhaps nothing threatens people more than change, and because of that, no part of benefits realization is more difficult than managing this change. A formal and robust change management program therefore is a fundamental requirement of benefits realization.

Benefits don’t just happen. Realizing clinical benefits from EHR implementation or optimization requires careful planning and expert delivery. It requires executive engagement and robust change management. Most especially, it involves an understanding that achieving benefits is a long-term continuous process that must be measured, monitored and fostered in order to ultimately achieve success.

To learn more about benefits realization, download the Impact Advisors white paper “Realizing Clinical Benefits from EHR Investments.”