Originally published on the Jive Software site on April 19, 2017 by Bill Klco.


The adoption of Electronic Health Record (EHR) systems by the healthcare industry has led to real improvements in medical record-keeping, but those gains have come at an enormous price. Hospitals and other institutions routinely spend hundreds of millions of dollars on their EHRs (also known as EMRs, for "Electronic Medical Record" systems), with some implementations topping $1 billion (8 Epic EHR implementations with the biggest price tags in 2015, 8 hospitals' finances hurt by EHR costs). The costs continue to rise as the implementations get bigger and complex.


And it doesn't end there. Even after rollout, the costs continue to pile up due to ongoing upgrades and optimization processes. On top of all that, clinicians often have trouble using the systems and incur expensive penalties for incorrect use.


Not surprisingly, EHR systems are a putting a serious financial strain on the healthcare industry, and can take a hefty toll on the bottom line. For instance, EHR costs contributed to a 15% drop in net income at one major health system in 2012, and forced another to lay off 130 people at three hospitals in 2015 (Unpacking hospitals' EHR implementation costs: What's behind the million-dollar price tags?). This comes at a time when healthcare providers are under intense pressure to trim costs and become more efficient.


The problem isn't simply that EHRs are expensive; it's the inability of healthcare organizations to fully reckon with and plan for all the elements a successful implementation entails. Nearly every EHR rollout is plagued by major cost overruns due to unanticipated expenses in areas such as training, additional hardware purchases, operational costs, consulting fees, and change requests and fixes required because of miscommunications and difficulty gathering and implementing feedback. It's these overruns – not simply the intrinsic price of the systems themselves – that are really hurting the healthcare industry.


Why do so many EHR implementations exceed their budgets? One big reason is a failure to fully address some key questions up front:

  • How do you effectively manage communications within the EHR selection committee?
  • How do you capture all the design and build decisions as well as validation test results, and how do you communicate progress?
  • How do you work with diverse stakeholders across a large health system to communicate and coordinate the rollout?
  • As EHR champions are identified, how do bring them together to share best practices and support each other?
  • How do you train users and administrators during the rollout and provide ongoing education on upgrades and new features?
  • How do you gather feedback and process improvement suggestions from clinicians after rollout?
  • How do you provide ongoing support to clinical and administrative users (on current and previous builds at the same time)?


These are critical considerations, but they're often overlooked because they involve communication technologies beyond the EHR system itself. Many organizations make the mistake of assuming that existing tools like email and support tickets will suffice, but none provides the kind of powerful conversational and cross-functional collaborative capabilities needed to connect all stakeholders, share information, gather feedback and work together in a timely way. Given that even simple changes within an EHR can cause major issues with interfaces, clinical workflows and training, it's not surprising that the lack of a suitable communication and collaboration platform can lead to all sorts of mistakes, inefficiencies and extra costs.


That's where new-generation clinical collaboration hubs come in. These systems provide a single destination for organizing, informing and connecting all parties involved in EHR usage, including clinicians, care teams, administrators, IT and other staff. State-of-the-art platforms provide a broad array of capabilities, including news and announcements; departmental portals; team collaboration spaces; individual and group communications; document collaboration; people directories; rapid search for people and content; and support spaces.


These functions provide a comprehensive answer to all of the issues listed above:

  • The EHR selection committee can manage all communications, documentation and decision-making around each phase of the EHR lifecycle in a single, private collaboration space.
  • The design and build process can have its own space, where all decisions and test results are captured and shared, and where updates can be pushed out to clinical staff.
  • Targeted blogs and tailored news feeds keep all stakeholders informed on the EHR rollout.
  • EHR champions can have their own spaces for education and knowledge-sharing.
  • Training spaces provide all the resources – including discussions, Q&A, documents and videos – needed to educate users and administrators on EHR use, upgrades and new features.
  • Collaborative hubs enable a wide array of two-way communications and feedback channels, such as the ability to comment and reply to communications and content.
  • Hubs offer a very efficient combination of self-service, peer-to-peer and staff-assisted support. For instance, users can quickly find answers by searching existing content, or submit their questions to be answered by knowledgeable colleagues. Staff can jump in to field or clarify any unanswered issues.


Whether you're implementing a new EHR, upgrading your existing system, or optimizing processes, a secure collaboration hub can save you substantial time, resources and money. It also improves clinician productivity with support through all aspects of EHR lifecycle, from selection through ongoing optimization efforts. Major health systems have saved millions of dollars in their EHR optimization efforts by streamlining project communication and clinician feedback using a collaboration hub. One Midwestern health system reduced their backlog of clinical change requests from over 8 months to 3 weeks simply by moving to a hub.


Creating a successful EHR system requires the expertise, understanding and contributions of many participants. A well-designed collaboration hub provides a place for all of that to happen. In doing so, it reduces risks, reins in expenditures, helps organizations reap much greater ROI from their EHR investments, and brings a new predictability to fiscal planning.

Want to end cost overruns on your EHR/EMR project? Learn more: HIPAA-Compliant Healthcare Communication | Jive Software