Over the past 10 years, US hospitals have rapidly adopted Electronic Health Record systems because of federal mandates that included both carrots and sticks. The US federal government pumped 87 billion US dollars into the market by giving multi-million dollar rewards to hospitals that adopted EHR systems and, in 2017, hospitals that have failed to do so will be penalized up to 2% of their Medicare payments.
This rush to computerize clinical care has been both a blessing and a curse for US hospitals many of which have seen their costs for IT skyrocket in spite of large government rewards and watched their productivity falter as complex systems slowed work and required extensive training. While some are now seeing benefits from this transition, the ongoing costs are challenging in a period of shrinking reimbursements from federal and state health programs.
Can hospitals in Mexico avoid the high cost of US-based systems while achieving better care, improved productivity and better profitability? One California company thinks so and is investing heavily in building a Latin American client base in Mexico and beyond. E-Health Records International (EHRI) has begun to market HarmoniMD, a Hospital Information System, in Mexico, Guatemala, Chile, Argentina and other Latin American countries which replaces paper charting for all clinical care processes.
While most of the HIS platforms currently in Mexico are add-ons to locally built business systems, HarmoniMD, EHRI’s flagship system, was designed as a clinical management system that integrates with imaging, lab, pharmacy and other software and addresses business needs like billing and inventory by capturing data in the clinical environment. In this way, HarmoniMD is able to eliminate the need for paper charting of patient care entirely and move hospitals completely to digital records. This includes all aspects of physician ordering including nursing orders, medications, lab, imaging, respiratory therapy, physical therapy and other departments.
To accomplish this, the EHRI team has built a unique system of Electronic Clinical Documents (ECDs) that can be customized to any hospital without any programming. These digital documents replace paper exam forms, order sets, evaluations, consent forms, surgery checklists and any other forms that the hospital needs with an easy to fill out digital interface. Most importantly, every clinical process can be mapped onto the workflow of the hospital and have easy to enter buttons, checkboxes and lists to reduce the amount of typing necessary to record patient information.
HarmoniMD is designed to run on inexpensive mobile devices like the 7-inch Lenovo tablet, which retails for less than $100US. This puts all of the workflow for nurses and doctors into their pockets thus eliminating the need to write down information and then type it into a computer. It also allows doctors to review any clinical information and place orders over the cell network from any location. Physicians are often surprised to find out that they can view x-rays and CT scans, see lab results, read nursing notes, see photos of patient conditions and place orders from any location with WIFI or cell 3G!
The biggest innovation EHRI is bringing to the Latin American market is a Software as a Service (SaaS) model that allows hospitals to pay for the system based on their patient volume and pass the cost of the system onto patients. With no up front costs for the software other than training and implementation, hospitals can get the benefit of improved productivity, charge capture, patient billing and clinical care without having to buy software or pay for future upgrades.
Nick Smith, E-Health Records International CEO, sums up the company’s approach as follows: ‘We built HarmoniMD from the ground up with the Latin American market in mind. We knew that we would have to be fully featured and attain the highest standards for any EHR system. At the same time we have to provide a return on investment for Latin American hospitals within the first year. Our goal has always been to keep not only the cost of our system as low as possible but also the cost of hardware and IT support affordable.’
Will these innovations help hospitals in Mexico to be more productive and profitable and to provide better care? Only time will tell but it will certainly be worth watching the early adopters of this system.