Using an EHR for Care Management? It Will Cost You.

Electronic Health Records (EHRs) have become ubiquitous across the healthcare landscape. Nearly 78% of office-based physicians and 96% of non-federal acute care hospitals use a certified EHR.

While EHRs offer significant benefits in managing clinical documentation, billing functions, and meeting regulatory compliance, they aren’t the most appropriate or cost-effective tool for addressing the holistic, longitudinal, and patient-centered needs of care management. 

In fact, repurposing an EHR for care management ultimately costs providers in various direct and indirect ways.  

Alternatively, adopting a built-for-purpose care management solution offers the most robust functionality. Care management software can fully equip the care team to support patients with chronic or complex conditions.

Why EHRs are not the solution for care management

According to an Institute of Medicine report, EHRs should offer the following eight core functions, including:

• Health information and data 
• Result management
• Order management
• Decision support
• Electronic communication and connectivity
• Patient support
• Administrative processes
• Reporting and population health

Today, EHRs are stretched thin with additional requirements and use cases that didn’t exist 20 years ago, such as:

• MACRA and MIPS performance tracking
• Revenue cycle management
• Customer relations management
• Patient-provider communication
• EHR alerts
• Speech recognition
• Financial dashboards
• Advanced clinical decision support
• Medication decision support
• Electronic patient information and education

In light of all the needs that EHRs try to meet, their impact is hurting clinicians rather than helping them.

With nearly 75% of physician burnout symptoms blamed on the EHR, it’s no wonder that 44% of primary care providers surveyed view the principal utility of an EHR as simply data storage. Approximately 59% believe EHRs need a complete overhaul.

Some research even points to evidence suggesting that EHRs may cause adverse patient safety events. Information overload caused by “note bloat” and cluttered interfaces can hinder critical thinking. Alert fatigue and poor visual displays can lead to increased error rates.

Related to the unique needs of care management programs, such as Chronic Care Management, Advanced Primary Care Management, Transitional Care Management, and Behavioral Health Integration, EHRs have consistently demonstrated they aren’t suitable for patient-centric care coordination.

Using an EHR for care management is going to cost you

ThoroughCare supports healthcare organizations with effective, evidence-based care management. Our team of in-house clinical experts, technologists, and industry specialists offers a proven and systematic model for analyzing, improving, and deploying care management programs.

Providers who reach out to ThoroughCare are usually aware of the challenges EHRs present for care management, and some insist they can use their current system. However, we’ve talked to many providers who’ve tried using their EHR and struggle to complete essential tasks, such as:

• Billing, time, program, and documentation compliance
• Care plan creation and updates
• Patient goal-setting, education, and engagement
• Community referrals and addressing social risks
• Patient-reported data
• Escalating risk triggers that require intervention
• Evidence-based disease management
• Identify and address gaps in care
• Population-health management

When providers attempt to use their EHR for care management, they tend to experience the following direct and indirect costs. These erode the program’s ROI, as well as patient and care team satisfaction.

Direct costs of using an EHR for care management

Lost revenue opportunities: Inability to enroll or manage a full panel of eligible Chronic Care Management patients.

Scaling limitations: Manual processes restrict growth.

Inaccurate billing: Poor tracking of time logs and care plan updates may lead to denials or audits.

Retrofitting expense: High cost of building or customizing EHR templates for care management.

Indirect costs of using an EHR for care management

Wasted staff time: Manual documentation and redundant processes.

Workflow inefficiency: Fragmented systems slow down patient interactions.

Compliance risks: Failure to meet CMS documentation and tracking requirements.

Missed outcomes: Lack of performance data leads to poor value-based care incentives.

Team dissatisfaction: Contributes to burnout, turnover, and disengagement.

Research published in the Journal of the American Board of Family Medicine (JABFM) revealed these costs when primary care practices used their EHR to integrate behavioral health care management and coordination.

The practices faced three main EHR challenges, including:

Data and documentation gaps: New clinician types (e.g., psychologists, nurse practitioners) generated behavioral health data that EHRs weren’t designed to capture in structured formats, making it hard to track and use for integrated care.

Lack of shared care plan support: Integrated care teams needed shared care plans and visibility into task completion, but most EHRs lacked templates to support coordinated workflows across disciplines.

Poor interoperability: EHRs didn’t integrate well with other systems or devices (like tablets), creating barriers to documenting encounters, accessing information at the point of care, and communicating between providers.

These practices incurred unexpected direct costs because their EHR didn’t meet the care management needs, which included paying for workarounds, customizations, and EHR upgrades.

They also experienced indirect costs they hadn’t thought about, including productivity loss due to workarounds, double documentation, duplicate data entry, scanning paper documents, and manual recall of clinical information

Ultimately, using the EHR as a care management tool diminishes the ability of any care management program to grow and scale. Inefficiencies and a lack of needed features, workflows, and intuitive interfaces limit the number of patients each care manager can oversee. This can frustrate the care team supporting the patient and keep the program and the patient from reaching desired goals.

Why ThoroughCare is best for care management

Unfortunately, even when EHR organizations add care management modules and bolt-on feature sets, the software still can’t provide the kind of longitudinal, personalized, and compliant guidance and workflow optimization that a built-for-purpose platform does.

ThoroughCare integrates directly with a variety of EHR systems (1), which eliminates double-entry challenges. Instead, the platform enables automatic importation of EHR information (2) and data sharing (3), where desired.

1. EHR systems that ThoroughCare integrates with directly

• AdvancedMD
• athenahealth
• Azalea Health
• DrChrono.
• Elation
• Epic
• gGastro
• Medent
• PointClickCare
• Veradigm Pro

2. Examples of patient data types ThoroughCare can automatically import

• Individual patient records
• ICD-9 and ICD-10 codes
• SNOMED codes
• Providers
• Insurances
• Allergies
• Lab Results
• Medications
• LOINC codes
• Vitals
• Encounters
• Immunizations
• Custom fields

3. Types of care management data that ThoroughCare can upload directly to an EHR

• Care plan report pdfs
• Update patient information
• Patient vitals
• Claims to be submitted

Robust interoperability ensures the care management team has seamless access to needed patient information. They can use that intel to engage patients efficiently, deliver interventions, and support timely education, goal-setting, and care coordination activities.

Beyond data sharing capabilities that underpin effective care management, ThoroughCare is designed to meet CMS billing, documentation, and programmatic requirements. Our solution also supports the specific workflows needed for each type of Medicare care management program, including but not limited to:

• Principal Care Management
• Chronic Care Management
• Behavioral Health Integration
• Transitional Care Management
• Remote Patient Monitoring
• Annual Wellness Visits
• Advance Care Management

ThoroughCare is purpose-built for chronic care and beyond, including: 

• Seamless enrollment, consent, and initial assessments
• Dynamic care plan creation and monthly updates
• Integrated patient health goals, vitals tracking, and time logs

ThoroughCare provides tailored workflows for clinical and operational efficiency, including:

• General health questionnaires, problem lists, barriers, and interventions are built in
• Shared care plan access for integrated teams
• Automatic tracking of care coordination, outcomes, and documentation

ThoroughCare enables comprehensive oversight and interoperability, including:

• Designed to support multiple care systems and benefit plans
• Tracks referrals, provider credentials, and authorizations
• Centralized platform for population health management and financial tracking

While EHRs are foundational to healthcare delivery, they’re not flexible enough for today’s proactive, integrated care models. Alternatively, ThoroughCare empowers care management and clinical teams to deliver better outcomes to more patients, at scale, with less friction.

Forcing an EHR to act as a care management system results in high costs, further provider frustration, and dissatisfied patients. ThoroughCare bridges the gaps EHRs create by offering a complete, interoperable, and purpose-built solution for chronic care and value-based care management, without the downsides of retrofitting or upgrading an EHR.

Key questions answered

Why are Electronic Health Records (EHRs) inappropriate tools for care management?

EHRs are designed for documentation and billing, not longitudinal care. Repurposing them for care management leads to inefficiencies, compliance risks, and staff burnout, as well as direct and indirect costs. Their lack of workflow support, poor usability, and limited interoperability hinder coordinated, patient-centered care, making a purpose-built solution like ThoroughCare a more effective, scalable alternative.

What are the direct and indirect costs of using an EHR for care management?

Direct costs of using an EHR for care management include retrofitting expenses, inaccurate billing, and limited scalability. Indirect costs involve workflow inefficiencies, wasted staff time, compliance risks, missed outcomes, and provider burnout. These challenges reduce ROI and hinder patient care, making EHRs ill-suited for longitudinal, patient-centered care management.