The Three Levers of Clinical Optimization

Incentivized by the meaningful use program, value-based care, ACOs, and so on, virtually every organization has adopted an EMR over the past decade. Physicians expected EMRs to improve their ability to respond to patient needs, have more face time with patients, increase their patient load, and manage those patients effectively.

Unfortunately, most providers feel like all four of those areas have gotten worse, not better. Now clinician frustration, burnout, and role dissatisfaction are higher than ever. Clinicians don’t feel like they can provide the care that they need to, get the outcomes they strive for, or build the relationships they want with their patients.

The Three Levers

In our Clinical Optimization Services 2020 report, we analyze the efforts of clinical optimization firms to help organizations realize the promised value of their EMR. There are three key levers almost all firms use that are proven to increase organizations’ EMR satisfaction scores: (1) workflow refinement, (2) application enhancement, and (3) clinician training.

Workflow refinement involves finding the most efficient way for physicians to work within their EMR and then redesigning those processes to improve effectiveness and satisfaction, often resulting in recommendations for application enhancement or training.

Application enhancement involves programing the EMR screens, controls, and reports to support the clinicians’ actual workflows, often resulting in the need for further workflow refinement or training.

Clinician training educates the end users on how to make the best use of EMR-based tools to care for patients; workflow refinement and application enhancement projects often lead to the realization that additional training might be needed.

Success as a Whole

The order of the three levers follows the logical progression that most health systems follow to approach clinical optimization. The levers come together to optimize and support each other. They are dependent on one another as a whole to create an effective optimization strategy.

The list below of optimization initiatives demonstrates how well the levers work together. Each of the initiatives is related to one of the three levers of optimization, as shown by the colored dots. After an initial EMR-satisfaction measurement, each initiative was invested in and completed before our follow-up measurement.  

Each of the three levers are fairly evenly distributed among the initiatives, supporting the levers’ interdependent nature. However, it is interesting to note that the lever which resulted in the highest improvement—clinical training—had almost the fewest number of validated engagements with investments focused on improvement initiatives that would fall under the training lever.

Drivers of Optimization

Training can be very expensive, and it’s hard to justify spending even more money to optimize. The cost for just 10 additional hours dedicated to training could easily result in millions of dollars due to clinician salaries and time out of the clinic.

The primary barrier to investing in clinical optimization is obviously money, even in the face of a clear need. Many health systems will spend hundreds of millions if not billions on technology solutions, so there have to be powerful drivers for organizations to be willing to make the additional investment to optimize their systems. Those drivers can include:

• physicians clearly expressing a need to improve the quality or efficiency of care
• the organization being unable to keep up to speed with system and application upgrades
• physicians retiring or leaving the health system due to burnout and dissatisfaction
• a variety of other competitive factors that would require optimization investments

An Optimal Future

When an organization commits to investing in clinical optimization, there are tangible benefits, not the least of which is patient satisfaction. In addition to the previously mentioned drivers, when EMR-based processes are optimized, patients get easier access to their records online, have shorter wait times, and have better interactions in the health system in terms of revenue cycle and collections.

Moving forward, we are going to see organizations come away from our current pandemic situation with a list of optimizations that they wish they had today to make their solutions more useful. We are also witnessing an evolution in regard to the EMR vendors themselves offering a more robust set of services around technology to help support clinicians.

Read more about the three levers and specific clinical optimization firms such as Atos, Chartis Group, Impact Advisors, NHA, and Nordic in our full report.