Report shows EHR integration improves lean production strategies

Over recent years, the health care industry has worked hard to push the adoption of electronic health records. These systems are designed to increase practice workflow and improve care quality.

According to a new report from the Agency for Healthcare Research and Quality, EHR systems assist practices in "lean production," which is a term coined by researchers at the Massachusetts Institute of Technology meaning the elimination of wasteful procedures and practices within health care organizations. 

Organizations adopt lean production to eliminate waste
The AHRQ's study defined lean production as getting rid of any waste that decreases resources, like time, staff or funding, without enhancing value or quality of care or workflow. The report examines six case studies that involve lean initiatives implemented by different health care organizations.

Some of these initiatives included improving the recording of outpatient data and outpatient EHRs. Each of these programs was adopted by Lakeview Healthcare, which was examined in the first case study. Interviews were conducted with nurses, doctors and other staff. The majority of the interviewees confirmed that the organization saw an improvement in practice efficiency, organization and employee satisfaction. In fact, Lakeview Healthcare executives reported that the incorporation of lean production initiatives led to a $29 million return on investment over the course of the past 14 years. 

Another case study came from Central Hospital in the Midwest. The organization focused on improving emergency cardiac care and incorporated management of surgical procedure cards into lean production. Lean initiatives have been implemented at the hospital before to improve care and the work culture.

EHR integration plays major role in lean production strategies
To fully implement lean production, EHR systems were introduced to the staff at Lakeview Healthcare through group training sessions in outpatient medical offices. Doctors were taught how to efficiently use an EHR in one-on-one training. The introduction of EHRs was meant to increase patient satisfaction and focus on a number of additional quality improvements.

The organization found that the incorporation of EHRs into the offices significantly enhanced patient flow in ambulatory care environments. Process improvement work was incorporated before EHRs were introduced to decrease the time and the risk of potential issues during implementation.

The small decline in productivity when EHRs were initially incorporated into daily workflows ultimately paid off. A management engineer from Lakeview Healthcare reported a reduction of 70 minutes in chart-filling time after the implementation was complete. The new EHR systems also decreased the waiting times for patients and improved patient satisfaction and safety. Results also signified a more organized environment and even a large improvement in teamwork and encouragement to achieve enhanced outcomes for their patients. This ultimately led to better employee satisfaction. 

"The use of technology meant integrated and improved patient safety processes," the report stated. "The management engineer reported that, as part of the larger value stream of projects that included the Surgeons' Preference Cards, patient safety improved as a result of checklists that were built into the computer system that could be used as a communication and debriefing tool."

The Grand Hospital Center, an academic medical facility, was the focus on the third case study. It used cardiology follow-up appointment scheduling as part of its lean program with the help of EHR and scheduling systems. The EHRs gathered important information to keep track of the organization's progress with its lean initiatives. EHR implementation also reduced discharge times by over three hours. 

The AHRQ report ended by confirming that the introduction of EHR systems has great potential to drastically reduce waste for health care organizations. EHRs are key to successfully adopting the lean production design, which improves everything from patient care to employee satisfaction.