Implementing a Custom EHR in a US Hospital Network: Driving $20 Million in Annual Savings

Our client is a large, multidisciplinary hospital network in the US, ranking among the top 15 largest in its region by patient volume, with an annual turnover exceeding $5 billion. Its extensive operations span key Midwest states like Ohio, Illinois, and Michigan. The network comprises over 30 hospitals, 150 specialized clinics, and 200 outpatient centers. Daily, they serve tens of thousands of patients, providing a wide range of medical services from primary care to complex surgical procedures.

Historically, the client faced several critical challenges due to outdated systems and manual processes that negatively impacted care quality, operational efficiency, and financial stability:

• Unsuitable off-the-shelf EHR solutions and high TCO risk

Despite attempts to implement standard EHR systems from leading vendors, these proved too rigid and inflexible to adapt to the unique, complex clinical workflows of multidisciplinary teams and various facility types (hospital, specialized clinic, outpatient center).

For example, standard modules couldn't effectively support specific protocols for managing patients with rare oncological diseases or multi-stage cardiac surgeries, requiring excessively expensive and labor-intensive customizations.

Such deep modifications to off-the-shelf systems often invalidated their standard certifications, creating high risks of HIPAA non-compliance with every update. This ultimately made the total cost of ownership (TCO) unacceptably high, with estimated additional annual costs for customizing and supporting third-party EHRs reaching $4-8 million without addressing the client's fundamental needs.

Estimated additional costs for customizing and supporting third-party EHRs could reach $4-8 million annually without yielding the desired results.

• Fragmented medical records and lack of a unified patient view

Patient information was scattered across numerous disconnected systems: outdated EMRs (Electronic Medical Records) in different hospitals, paper charts in outpatient clinics, and separate systems for labs, radiology, and pharmacies. This led to a lack of a complete and up-to-date overview of a patient's medical history, hindering care coordination and increasing the risk of medical errors.

• Low operational efficiency and high administrative burden

Clinical and administrative staff spent an excessive amount of time (up to one-third of their workday) on routine, repetitive tasks: manual data entry, searching for information across different systems, filling out paper forms, and faxing referrals. This reduced productivity, caused staff burnout, and increased operational costs.

• Data security threats and HIPAA compliance complexities

Storing sensitive patient data in disparate, often outdated systems created serious vulnerabilities to cyberattacks and unauthorized access. Adhering to stringent US federal and state regulations for patient data protection, such as HIPAA (Health Insurance Portability and Accountability Act), as well as HITECH Act standards, was extremely labor-intensive and carried high risks of multi-million dollar fines for violations. The risk of HIPAA fines reached hundreds of thousands to millions of dollars per incident, not including reputational damage.

• Lack of clinical decision support tools

Physicians lacked quick access to aggregated patient data at the point of care, as well as intelligent tools that could provide up-to-date clinical guidelines, drug interaction alerts, or potential allergy warnings. This increased the likelihood of errors in diagnosis and treatment.

• Patient engagement challenges

Patients lacked convenient access to their medical records, lab results, online appointment scheduling, or secure communication with physicians, which reduced their engagement in the treatment process and overall satisfaction.

Facing the critical challenges outlined above, the client turned to Emerline.