{"id":19701,"date":"2016-11-18T17:19:44","date_gmt":"2016-11-18T22:19:44","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/un-breaking-healthcare-athenahealths-use-of-electronic-health-records\/"},"modified":"2016-11-18T17:19:44","modified_gmt":"2016-11-18T22:19:44","slug":"un-breaking-healthcare-athenahealths-use-of-electronic-health-records","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/un-breaking-healthcare-athenahealths-use-of-electronic-health-records\/","title":{"rendered":"\u201cUn-breaking\u201d healthcare: athenahealth\u2019s use of electronic health records"},"content":{"rendered":"

I spent the last few minutes of my doctor\u2019s visit in early 2013 in silence, as my doctor clumsily typed away notes about my progress. He apologized before he started typing, complaining that he was being forced to transition from paper-based notes to a new computer-based system with which he was unfamiliar. This moment was awkward, but it represented an important trend in healthcare delivery improvement.<\/span><\/p>\n

Electronic Health Records in the U.S.<\/strong><\/p>\n

In 2015, 84% of primary care physicians in the United States used electronic health records (EHRs). The U.S. trails countries like Australia and the United Kingdom in this respect, where EHR penetration levels among primary care physicians were 92% and 98%, respectively.[1] This discrepancy represents both a performance gap for the United States and an opportunity for continued innovation. The quality benefits of shifting to EHRs are well known; as a result, EHRs have been promoted by the Obama administration and a number of prestigious hospital systems, such as Partners HealthCare.[2,3] A University of Michigan study found that an increase in EHR usage by 1 standard deviation was associated with a 5.3% increase in physician productivity.[4] However, these innovations have not made their way into every American\u2019s primary care visit, which is shocking considering the amount of health care spending in the U.S. — over 17% of GDP and over $9,000 per capita.[5] <\/span><\/p>\n

Enter athenahealth<\/strong><\/p>\n

athenahealth is one of the companies taking on the challenge of improving health care operations at scale. It aims to not only give providers access to EHRs but also optimize their usage of EHRs over time. In addition, athenahealth provides a number of technology and cloud-based services to practices to help manage various challenges embedded in the operations of a typical physician practice, including revenue cycle management and clinical decision support.[6] <\/span><\/p>\n

One of the most salient features of athenahealth\u2019s offering is that it provides very little customization to its customers. Rather, it runs a single instance of its software across all of its providers in a cloud-based network fashion.[7] There are a number of benefits to this approach:<\/span><\/p>\n

    \n
  1. Scale:<\/strong> athenahealth can scale its growth relatively quickly by providing a consistent product to a variety of new customers that takes much less time to install and upgrade than a customized product.<\/span><\/li>\n
  2. Best practice sharing and optimization:<\/strong> athenahealth can collect a ton of data from providers simultaneously regarding their productivity with the service. If athenahealth discovers an optimization opportunity from one provider group, it can easily adjust its product to benefit all of its providers.<\/span><\/li>\n
  3. Lower upfront costs:<\/strong> less installation time allows athenahealth to spend less on labor designing and setting up the product, which makes it more affordable for athenahealth to acquire new customers. On the provider side, athenahealth doesn\u2019t have to charge high setup fees. In fact, for many of its products, athenahealth charges nothing upfront. Instead, athenahealth makes money only when its providers are appropriately reimbursed, aligning its business incentives with the provider\u2019s operations.[8]<\/span><\/li>\n<\/ol>\n

    Opportunities<\/strong><\/p>\n

    Looking ahead to the future, there are at least two potential areas in which athenahealth should focus its energies:<\/span><\/p>\n

      \n
    1. Moving from primary care to hospitals:<\/strong> While healthcare overall is a sizable portion of U.S. GDP, hospital care is the largest single component of health care spending (~32%).[9] With that said, athenahealth only holds significant market share within primary care – it\u2019s not even mentioned among the top hospital EHRs despite the fact that it provides the service.[10] Its lack of customization leads to product features that are less robust than what large academic medical centers require. However, there may be significant revenue upside in competing in the hospital market.<\/span><\/li>\n
    2. Building interoperability with other EHRs:<\/strong> Across the country, there has been a recent trend of consolidation in the provider market, with many providers merging (or developing clinical affiliations) with each other.[11] If an athenahealth customer gets acquired by a non-athenahealth customer, athenahealth may lose that customer if the acquirer implements its system across its consolidated network. While athenahealth can attempt to win in the hospital market, a more feasible approach to defending revenue might be to try to allow its technology to communicate with that of nearby competitors. <\/span><\/li>\n<\/ol>\n

      The work of athenahealth and a number of its competitors is incredibly important for the future of health care, although it often goes overlooked when compared to more \u201chigh-tech\u201d innovations. Achieving the basic goal of appropriate information-sharing is a difficult challenge to solve, but it\u2019s fundamental to patient care. It has been very promising to see this aspect of the system show some signs of progress.<\/span><\/p>\n

      Word count: 770<\/span><\/p>\n

      References:<\/p>\n

        \n
      1. \u201c2015 International Profiles of Health Care Systems.\u201d The Commonwealth Fund, January 2016.<\/span><\/li>\n
      2. Partners HealthCare, 2016. \u00a0<\/span>http:\/\/innovation.partners.org\/healthcare-information-technology-hit<\/span><\/a><\/li>\n
      3. Centers for Medicare and Medicaid Services, 2016. <\/span>https:\/\/www.cms.gov\/Regulations-and-Guidance\/Legislation\/EHRIncentivePrograms\/index.html?redirect=\/ehrincentiveprograms\/<\/span><\/a><\/li>\n
      4. Adler-Milstein J, Huckman RS. The impact of electronic health record use on physician productivity. Am J Manag Care. 2013 Nov;19(10 Spec No) SP345-52. PMID: 24511889.<\/span><\/li>\n
      5. \u201c2015 International Profiles of Health Care Systems.\u201d The Commonwealth Fund, January 2016.<\/span><\/li>\n
      6. athenahealth, 2016. <\/span>http:\/\/www.athenahealth.com\/<\/span><\/a><\/li>\n
      7. ibid<\/span><\/li>\n
      8. ibid<\/li>\n
      9. Centers for Medicare and Medicaid Services, \u201cNational Health Expenditures 2014 Highlights.\u201d <\/span>https:\/\/www.cms.gov\/research-statistics-data-and-systems\/statistics-trends-and-reports\/nationalhealthexpenddata\/downloads\/highlights.pdf<\/span><\/a><\/li>\n
      10. Green, Max. \u201c50 things to know about the EHR market\u2019s top 50 vendors.\u201d Becker\u2019s Health IT & CIO Review, Jul 6 2015. http:\/\/www.beckershospitalreview.com\/healthcare-information-technology\/50-things-to-know-about-the-ehr-market-s-top-vendors.html<\/span><\/li>\n
      11. Cuellar, Alison Evans and Paul J. Gertner. \u201cTrends in Hospital Consolidation: The Formation of Local Systems.\u201d Health Affairs, vol 22 no 6, November 2003.<\/span><\/li>\n<\/ol>\n

        Featured photo credit: www.athenahealth.com<\/p>\n","protected":false},"excerpt":{"rendered":"

        athenahealth is using technology to improve the healthcare system – but can its model compete with larger companies?<\/p>\n","protected":false},"author":2251,"featured_media":19703,"comment_status":"open","ping_status":"closed","template":"","categories":[2029,2560],"class_list":["post-19701","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry","category-digitization","category-electronic-health-record"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/digitization-challenge-2016\/","yoast_head":"\n\u201cUn-breaking\u201d healthcare: athenahealth\u2019s use of electronic health records - Technology and Operations Management<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/un-breaking-healthcare-athenahealths-use-of-electronic-health-records\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u201cUn-breaking\u201d healthcare: athenahealth\u2019s use of electronic health records - 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