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Transform healthcare by leveraging the EHR

Implementing and integrating an EHR in a healthcare organization is one important step in transforming healthcare, but it is not, and should not, be the sole focus.

There's no doubt that EHRs play an important role in helping organizations transform healthcare. But they also serve as a hindrance in some ways; for example, the lack of interoperability. Charles Macias, M.D., an attending emergency department physician and chief clinical systems integration officer at Texas Children's Hospital in Houston, spoke with SearchHealthIT at HIMSS 2016. He gave advice not only on installing and implementing an EHR -- specifically Epic Systems Corp.'s HER -- but he also made the point that if healthcare organizations' sole focus in their efforts to transform healthcare is the EHR, not much will get done. 

Do you have any advice for other hospitals or healthcare organizations that are currently trying to install and implement an EHR, such as Epic?

Charles Macias: The first thing I would say is that if you're looking for a solution to transform healthcare, it's not going to come from your EMR [electronic medical record]. It's going to come from clinical transformation, it's going to come from quality improvement and improvement science and it's going to come from understanding the analytics and making it actionable.

Charles Macias, M.D., attending emergency department physician and chief clinical systems integration officer, Texas Children's HospitalCharles Macias, M.D.

So if you are taking Epic in isolation, look for either growing your organization's scope of interest and engagement in those other areas or understand and change your expectations for how quickly you're going to be able to get there because it will take [Epic] time to get there.

A lot of our philosophy to merging all of that work comes from what we call clinical systems integration. It's really borrowed from universal payer models that [have] single payer systems. Presumably there's a much more unified dataset in the world of data that you can pull out there. What we've learned from the Canadian system and the British system is that despite having those universal payer models, it's not enough because it's missing that actionable piece. There are great pockets of demonstrated efforts and outcome and the transformations of components of healthcare, but it really takes a concerted effort of taking the best science and converting that to evidence-based standards that you can infuse into the provider's practice.

The second component of that is the analytics behind it. How do I understand what's happening in those populations? And then how do I predict what they're going to do to translate that into that third component which is quality improvement, how to improve the outcomes from that? Being able to work in those different domains means that no one piece is going to give you the right answer. 

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