Family physician Saroj Misra is an educator, and thinks that physicians are at the low end of the learning curve when it comes to EHRs.
"Despite the fact that we've had EHRs in some form or another for the last 15 to 20 years … we are surprisingly behind the times in terms of how they work; what they do, and, most importantly from a physician's perspective, how they help in the delivery of healthcare," says Misra.
That is probably a perspective that many physicians would share. In the 2015 Physicians Practice Technology Survey, Sponsored by Kareo, only 53 percent of 1,181 respondents said they had a fully implemented EHR system. And, despite seeing an improvement in documentation (66 percent), 68 percent said they did not see a return on their investment in EHR. Respondents said one of their top information technology problems was "a drop in productivity due to our EHR," indicating a significant disconnect between the intent of EHR and its reality.
If you are wondering what EHR trip-ups other physicians are struggling with, our experts tell us these areas are the worst offenders.
Inadequate training on EHR systems for both physicians and clinical staff can be a significant source of frustration. Yet there are many other demands for a physician's time and money. It is a paradox that devils many practices: If a practice doesn't go "off line" and dedicate enough time to initial training on the EHR, implementation and subsequent productivity will suffer. But few practices can afford to take a full week or more away from patient care.
Tom Giannulli, chief medical information officer for EHR vendor Kareo, counsels physicians to avoid learning a new system while they are seeing patients. "EHRs have learning curves, for some they may be steep, and if you do not ascend the curve in a productive learning environment, you will be paying for it with wasted time and frustration," he says.
Misra, who directs the development and implementation of curriculum at Michigan State University's College of Osteopathic Medicine, incorporates technology use in his teaching. He says in order to have true success with understanding and efficiently using the EHR, physicians need to "commit time each week to relearning [the system]." He gives the example of a "power-user" who goes beyond learning basic system functionality and commits time each week to really learn what the system can do. Understandably, that might sound like a pipe dream, given the lack of excess time in a busy practice. But there are ways around that limitation. Misra recommends carving out one to three hours each week for a single physician or staff member to learn the functionality of the practice's EHR. "Then, that person becomes a liaison or a de facto liaison to the EHR vendor," he says, "but also a person who can educate and provide ongoing education for the physicians and the office staff."
• Training should be timely, and repeated for both new staff and current users.
• Training should focus on specific tasks that staff/providers will use daily.
• Identify a practice "super-user" who will be a clinic resource/trainer/ IT support person.