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Ambulatory providers have experienced significant change over the past decade as advances in health information technology (HIT) have sought to transform the way care is provided. The COVID-19 pandemic has further influenced this transformation with the rapid adoption of new tools, and increased patient expectations about how technology should improve the access, availability and continuity of care received from their provider.

To fully understand the challenges and best practices for HIT adoption in ambulatory care settings, NextGen Healthcare commissioned Xtelligent Healthcare Media to conduct a survey of leaders at these healthcare organizations. The survey is one of a quarterly series to monitor HIT adoption and key trends in ambulatory facilities. This quarter's report emphasized patient engagement solutions to understand the technology's relationship with overall HIT strategies.

Results highlight four key trends:
1. HIT solutions need to be integrated with existing technology systems to be optimized 
2. Provider burden is eased with the right HIT solution
3. Patient engagement HIT solutions enable financial success and patient access 
4. Successful patient engagement solutions also ease provider burden

Challenges to patient engagement technology adoption parallel that of general HIT adoption. Regardless of the specific technology, successful rollout and optimization in an ambulatory care setting depend on integrating existing systems to ease provider burden, enable financial success, and improve patient access.

Trend 1: HIT Solutions Must Be Integrated with Existing Systems

Among survey respondents, most are well underway in their HIT adoption journey. Sixty-seven percent of ambulatory center stakeholders say their HIT solutions are in place, and they are working to optimize these solutions.

Optimization is why most respondents (83 percent) say HIT is a medium to high priority at their organization. Stakeholders want to utilize these technologies to their fullest potential and see proof of their impact on patient outcomes, provider workflow, and financial success.

HIT solutions in place that are not optimized cannot push organizational strategy forward. Rather, disparate technologies often slow provider workflow and inhibit care coordination. One of the biggest considerations executives at ambulatory care facilities make when selecting HIT solutions is interoperability with existing systems, with 58 percent of survey respondents citing this as the most significant factor in HIT solution adoption.

Trend 2: HIT Solutions Should Ease Provider Burden

Many ambulatory provider organizations have HIT solutions and are working to optimize their use for providers, staff, and patients. But there are several barriers to successful adoption and optimization, including limited workforce, financial resources, and tailored solutions.

The biggest challenge to successful HIT adoption, though, is provider adoption. Nearly one-third (31 percent) of ambulatory care executives note that provider uptake of these technologies is the greatest barrier to successful rollout and use. Over half (51 percent) of practices indicated they were increasing their education and training on the appropriate use of HIT solutions to ease the burden on providers due to this concern.

Trend 3: Patient Engagement Strategies Play a Large Role in Financial Success and Patient Access

The growth of consumerism in healthcare means patients increasingly expect the same convenience, quality and consistency of service they are used to receiving as consumers outside of healthcare. Patients want their healthcare experience to parallel the convenience they find in their personal lives with online retail, financial or travel services. As a result, patients are demanding convenient, easy-to-access technology, and this is helping to drive provider organizations to select and implement patient-facing solutions which facilitate a smoother, more timely and service-focused experience.

Engaging patients in care more effectively begins with delivering on this need, but the long-term impacts for an organization must also facilitate better patient outcomes and financial success. Unsurprisingly, 83 percent of survey respondents believe patient engagement solutions play a medium to large role in patient outcomes and organizational financial success.

Key functionalities according to ambulatory care stakeholders include pre-visit or check-in workflows (76 percent) and telehealth (68 percent). These two capabilities help reduce the administrative burden on front office staff, reduce the amount of time spent in office completing paperwork and with telehealth, reduces the number of missed appointments, thus improving patient access.

Trend 4: Successful Patient Engagement Depends on Minimizing Provider Burden

Like HIT solutions generally, the success of patient engagement technologies depends on provider adoption; providers are resistant to technologies that interrupt their workflows or add undue burden.

Patient engagement technologies—like all HIT solutions—should integrate with existing workflows and platforms. Nearly all ambulatory care executives (95 percent) believe these qualities are moderately or very important in a HIT solution.

Hesitancy around adopting new technologies and concerns about data volume, data accuracy and responsibility for including such data in their practice records were some of the concerns shared about introducing remote patient monitoring solutions. Sixty-two percent of survey respondents are concerned about adopting novel technology like remote patient monitoring solutions due to an anticipated increase in clinicians' workload. Many are also worried about large volumes of unfiltered data (48 percent) and clinician liability for that data (45 percent).

Patients want telehealth solutions, which include remote patient monitoring technologies, but adding work for clinicians stands in the way. Whether it is immediate in a provider's daily workload or the looming responsibility for data collection, storage, and interpretation, leaders must remain mindful of technology's impact on their workforce.


As these survey results show, patients are demanding technologies that make it easier and more convenient for them to access care. Solutions that engage patients in their care can help drive organizational success and meet patient expectations.

To help drive adoption, decision-makers must consider the impact of these solutions on provider workflow, including patient engagement technologies. While these solutions increase patient satisfaction and access, integration into existing systems and clinical workflows are crucial considerations to ensure they do not add an undue burden on providers.

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Graham Brown

Graham Brown

Senior Vice President, NextGen Advisors

Graham Brown is a principal and senior vice president with NextGen® Advisors focused on transforming care with provider organizations. His practice centers on accountable and value-based care strategy, population health management programs, and technology solutions for providers enabling new models of care delivery across the United States.

Mr. Brown is a former senior vice president and national practice leader for population health and clinical integration with GE Healthcare Partners (previously The Camden Group) where he led multidisciplinary client teams in strategy creation, program development, implementation, operations, and performance optimization engagements. He is an experienced leader in organizational development, managed care contracting, and change management initiatives.

Mr. Brown has over 25 years’ experience supporting provider groups, health and hospital systems, integrated delivery networks, and managed care payers to assess, design, contract, and implement systems and structures for population health management. He has worked nationally across the United States and Canada.

Graham completed his undergraduate studies at the University of Victoria, the Emily Carr University of Art and Design, and the Instituto Europeo di Design in Florence, Italy. He is certified in conflict resolution and negotiation by the Justice Institute of B.C. and received his Master of Public Health from the University of Rochester Medical Center.