PwC Finds EHRs Require Careful Analysis to Reduce Risk, Save Money

Analytics can help health care providers discover compliance issues faster, bolster data security and generate more revenue, a report from PWC concludes.

In 2009, the United States signed into law the American Recovery and Reinvestment Act, which called on the country to modernize U.S. health records within six years. Part of that law was the Health Information Technology for Economic and Clinical Health Act, which provided nearly $26 billion in federal funds to modernize health care IT. Billions more funneled into health care IT efforts in subsequent years, but without those acts, the implementation of EHRs would have been sketchy at best.

Federal regulations are forcing hospitals and other health care providers to implement EHRs under tight timeless, according to PwC. The firm found that health care IT professionals are forced to adopt advanced EHR platforms for major facilities, but aren’t given the time it takes to do it right. That can often create gaps that result in costly issues.

The sheer number of challenges facing health IT in implementing EHR systems is shocking. In speaking with professionals, PwC found that IT professionals are first forced to deal with system integration issues and ensuring that the new EHR systems work with existing IT infrastructures. From there, IT pros need to be schooled on compliance and administrative risks that go along with safeguarding patient data. Simply put, there are pitfalls at every turn.

In one case study, PwC pointed to a health care organization that used only sample testing to evaluate the EHR’s operation. The company discovered errors in record formats, with fields in the wrong areas and patient services being billed to the wrong insurance companies, resulting in lost revenue. While this sample testing approach was able to catch some issues mainly through sheer luck, it did not test all facets of the data-protection and revenue cycles. That was a serious problem.

The lesson that PwC’s research teaches is that implementing EHRs requires system-wide testing. In every case, PwC argues, companies need to use system-wide data analysis to determine whether the EHR system can adhere to compliance regulations and “deliver the precision that regulators are demanding.” The consulting company added that new data-mining and data-visualization tools (which it did not identify) can find all of the trends or aberrations that become costly issues when EHRs go live.

The time has finally come to go live with EHSes. Now what? According to PwC, companies often face “patient safety concerns, fee charging errors, revenue leakage, interoperability challenges,” and even problems with medical devices and printers when going live. To address those issues, PwC recommends that IT pros analyze “upstream and downstream workflows” to find where the issues are. Companies that also use sophisticated analytics programs that work with their existing technology infrastructure can go a long way toward rooting out problems.

PwC says that its study of the health IT market shows that handling EHR data is a process. That process begins with having dependable data that is properly analyzed by a tool that can look at “clinical systems, modules and inputs.” From there, the EHR platform goes live and its data is mined and tested for accuracy and integrity. When the analysis tools discover problems, PwC said, health IT pros can use the mined data to improve operations and achieve cost-savings.

One of the biggest challenges facing health IT professionals after EHR implementation, however, is handling vast amounts of data. PwC found that when health care providers implement EHRs, often several different data sources are used to create a record. It’s necessary, therefore, for health IT professionals to integrate those varied data sources into a single usable dashboard that monitors inputs continuously. PwC found one company that did just that. The company’s dashboard ran an audit that found several inefficiencies three years after implementation. The findings helped the company save more than $3 million in potential losses.

PwC pointed to one company that lost $2.5 million due to revenue leakage caused by not continually monitoring EHR data. On the other hand, PwC has found that it’s possible for large health care organizations to save tens of millions of dollars by analyzing billing and ensuring patients and insurance companies are properly invoiced. In one case, proper analysis delivered more than $16 million in cost-savings.

Data analysis is critical to success with EHRs. But that’s just the tip of the iceberg. PwC found that EHRs can positively impact hospitals and other major health institutions, as long as the IT side has the ability to continuously monitor communications in real time. The consulting company also argued that health IT professionals must have “enhanced oversight, auditing, and controls necessary to realize the potential that EHR systems tantalizingly offer.”