‘Your investment is literally washed away’: Why CIOs stick with the EHR-first strategy

A few weeks ago, CIO of Richmond, Ind.-based Reid Health Muhammad Siddique was doing a round of the ED department when he ran into one of his physician colleagues. She stopped to make a quick but meaningful comment.

“She looked at me, glanced at my computer, and said, ‘You know what? I spend more time fighting this computer than I do connecting with my patients’,” said Mr. Siddique. “That moment really hit me hard as a chief information officer.”

While challenging to hear, the physician’s comment reinforced Mr. Siddique’s commitment to an EHR-first strategy. Health systems across the U.S. are pitched new AI-driven products and point solutions on a daily basis to solve a variety of small friction points; communication between providers, scheduling, ambient listening for note taking, and more.

But that’s not what Mr. Siddique is looking for.

“We don’t want to implement more fragmentation into our health system, which is already too fragmented,” he said. “We can go and buy 10 different third party applications. They can go on top of Epic, Oracle Health, Meditech, any system, but that means you are adding fragmentation, not only for your clinicians, but for your patients as well.”

Installing new technology is expensive and time consuming; it requires leaders to forge new partnerships, purchase the solution (and sometimes pay monthly subscription fees or add-on fees) and then time and energy to train the staff. By the time a new point solution is integrated, there may be a better product on the market.

“When you have a scheduling system in one place, like a mobile application, and in a second place you have a billing system, and if they aren’t directly interconnected, for me that’s useless,” said Mr. Siddique. “That’s not digital transformation. Every time you implement a third party application, two months later, in our case, Epic comes out with the same product. What’s going to happen? Your investment is literally washed away.”

Fragmentation within the hospital’s digital application can also lead to patient confusion and frustration. The patient digital experience is important, and that’s why Mr. Siddique is trying to limit third-party vendors by focusing on the applications already integrated in the EHR.

“We have disconnected tools that don’t talk to each other and that starts creating confusion for the patient,” he said. “And one of the biggest crises that we deal with today is clinician burnout. Lots of providers are leaving the profession because they burn out over documentation, in addition to other reasons. That is top of mind for me as well.”

The slower approach hasn’t hurt the health system’s innovation. Mr. Siddique said he is “anti-fragmentation,” not “anti-innovation,” which is especially important as margins tighten and clinician shortages persist.

“The cost pressure for all CIOs in U.S. healthcare is there. Every tool has a human cost, a clinician who burned out and the IT team is stretched thin nowadays,” he said. “We don’t have the luxury of hundreds of people working in it anymore. Our job is not just buying tools, it’s to make the tool work. The adoption and utilization of the tool that we are implementing is a critical factor now.”

Many health system CIOs have 100-plus applications, and Mr. Siddique estimates about half of the applications typically aren’t utilized. He has focused on that utilization to take Reid Health from an Epic Gold Star 2 to Gold Star 10 system.

“My view or recommendation is to utilize what you already have available today in full capacity,” said Mr. Siddique. “I guarantee if you look around, you have under the hood so many other features available that we’re not using today.”

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