The way in which physicians interact with data as it pertains to patient care has clearly identified the EHR as a critical tool. The statistics speak for themselves — approximately 78 percent of all office-based physicians had an EHR in place as of 2013, according to a 2014 study in Health Affairs. However, this doesn't mean that physicians are satisfied with the EHRs they have; recent studies, including a 2014 report in JAMA Internal Medicine, have shown that even experienced EHR users find significant decreases in productivity, losing on average, 48 minutes of productivity every workday. It becomes critical, then, to find ways to maximize the use of existing EHRs in an effort to improve efficacy for patient care and reduce end-user frustration.
The biggest problem with an EHR system is not the product itself — it is the way we learn to use it and how we communicate with those who make and update it. These five strategies might help to reduce both the frustration level and inefficiency that many doctors feel come with their EHRs.
1. Train and train again. Most EHR training occurs prior to "going live" and is often not tailored to individual "teams" within the office (medical assistants, front-desk staff, physicians, billers). In addition, once the initial training is done, most offices rarely do any further training. The reality is that "relearning" your EHR is critical to maximizing its advantages. Consider appointing one individual in your office (or one from each stakeholder group) to set aside time each week or month to "retrain" on the EHR. The focus should be on capabilities (what can it do) and needs (what do we need it to do).
2. Check your "flow." Work flows in your office need to be looked at before and after an EHR is implemented. Have your office manager and/or you (the physician) spend a day watching how a patient moves through the process of being seen — from check-in to check-out. When you identify choke points (be they people or processes), work on how to fix and redirect those tasks.
3. Use shortcuts. Most EHRs have huge amounts of customizability that physicians often forget to take advantage of. Learn how to use encounter templates and order sets to speed the process of getting data into the system. Don't forget about dictation and transcription capabilities as well.
4. Engage the portal. Using the patient portal to allow patients to manage common tasks and requests can dramatically reduce the amount of work your staff needs to do. Recent CMS guideline changes allow for reimbursement of "non-face-to-face" visits for chronic diseases — using the patient portal as a tool for this type of patient interaction is an optimal strategy.
5. Communicate with the vendor regularly. It's important to remember that you are a client when it comes to the EHR and that you are paying for services as well as product. Don't hesitate to ask for further training or retraining if needed. Make sure the EHR vendor has regular meetings with your office staff designee to keep you updated on changes to the EHR system.
Strategies such as the ones above will help your practice get the most out of the EHR it has, while waiting for the day when healthcare has an EHR physicians actually want.
Saroj Misra, DO, FACOFP, is an osteopathic physician based in Warren, Mich. He is also a member of the Physicians Practice Physician Advisory Board. Are you frustrated with your EHR system? Tell us at [email protected]. Unless you say otherwise, we'll assume that we're free to publish your comments in print and online.
This article originally appeared in the July/August 2015 issue of Physicians Practice.