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Self-Service: The Role Patients Can Play in Optimizing EHR Adoption and Its Impact
By Tim Heffernan

As the American Recovery and Reinvestment Act (ARRA) spurs greater adoption of EHRs nationwide, the industry’s primary focus has been the technology’s impact on clinicians and what constitutes meaningful use. While this is a logical place to begin, the transition to EHRs presents an equally significant opportunity to redefine the healthcare experience for patients. In fact, building a national HIT structure that includes self-service technology will complement EHR use, expedite its benefits, and empower patients to be more active participants in their care.

For example, a major obstacle that providers face when converting from paper-based to electronic records is digitizing the large volume of paper forms that must be managed daily, including consent documents, registration forms, and privacy notices. Reliance on paper-based methods presents challenges for healthcare staff looking to move patient data from paper forms into clinicians’ hands. Many providers address this issue by manually scanning documents into the relevant information systems or reentering data, including demographic, insurance and medical history details, that patients provide on printed forms. This approach diminishes the cost, quality, and efficiency gains that EHRs were designed to create. By capturing patient data electronically through self-service kiosk, online, and mobile applications at the beginning of a patient encounter, healthcare providers can create a truly paperless workflow and eliminate the inefficiencies and potential errors that stem from these workaround solutions.

Why Self-Service?
EHRs do not operate in isolation. To achieve the desired gains in care quality, safety, and efficiency described in ARRA, EHRs must operate within a framework that promotes the secure exchange of clinical data at the regional and national levels. Effectively building an infrastructure of regional health information exchanges as well as the Nationwide Health Information Network requires the use of enabling technologies that facilitate interoperability by making data available in a format where they can be easily shared between systems. The bulk of attention concerning this effort has been on back-end solutions, such as data-exchange standards, but little consideration has been given to how the data will be converted from paper to an electronic format—an important first step in the process. So while standards are a key component to achieving interoperability, patient-facing solutions such as self-service can also help the industry make strides toward its desired goals by creating a mechanism for capturing vital patient data and automating form collection throughout the continuum of care.

When patients check in for an appointment utilizing self-service technology, the data entered by the patient are immediately available in a format that can be exchanged with other IT systems, including admission/discharge/transfer systems, clinical data repositories, practice management systems, and EHRs. Through the use of Health Level Seven International and other interface protocols, self-service captures data in a way that minimizes the delay between the time patients provide the information and the time it is made available to the care provider. As a result, patients experience shorter wait times and providers benefit from quicker access to data.

Consumer-Driven Care
As patients take a more active role in managing their care, they need access to tools and resources to help facilitate this shift in control. Self-service empowers patients by enabling them to enter demographic, health, and insurance data electronically at the beginning of an interaction so they can better manage their personal information and minimize the potential for error. Extending data capture to patients also eliminates the need for redundant paperwork, which speeds the check-in process, reduces wait times, and improves patient flow throughout the care process. This added convenience not only enhances the patient experience and boosts patient satisfaction, but it also has a measurable impact on the accuracy of data collected during the registration process.

Early Adopters
To date, more than 6 million patients have checked in for medical appointments at healthcare organizations nationwide using self-service technology, and the experiences of these early adopters demonstrate how providers can deploy these tools to enhance the use of EHRs and provide better service to patients.

The Medical Center of Central Georgia (MCCG) implemented self-service check-in in 2007 to alleviate staffing challenges and automate cumbersome manual processes such as reentering patient data, scanning forms into the EMR system, and filing paper registration forms. Since its deployment, the MCCG has cut patient wait times by increasing the number of patients that can check in simultaneously from two to 10, and optimized staff resources by increasing its staff-to-patient ratio from 1:1 to 1:6.

As more healthcare providers adopt self-service, the cumulative impact of the resulting productivity gains will be significant. In fact, a recent report issued by the Information Technology & Innovation Foundation states that if self-service were more widely deployed across all industries, the U.S. economy would be approximately $130 billion larger each year, or the equivalent of an additional $1,100 in annual income for each household.

At a time when the healthcare industry is embracing the broader, patient-centric use of IT, self-service offers a viable way to reduce healthcare expenses, optimize provider investments in EHRs, and expedite their benefits. An integral part of a common infrastructure that includes EHRs, self-service applications help to facilitate real-time data exchange between ancillary systems and platforms, creating a model for improved efficiency, lower costs, and a better patient experience.

—Tim Heffernan is chair of the HIT committee for the Information Technology Industry Council and vice president of global government relations and communications for NCR.