Electronic health records have markedly changed the way patient care is managed. Carrying an array of benefits, including offering greater clarity of information, eliminating the need for paper-based storage and streamlining work loads, EHRs are now widely adopted by physicians across the country. Indeed, statistics from The Office of the National Coordinator for Health Information Technology reported that toward the end of 2015 a vast majority - close to 87 percent - of physicians nationwide, based in offices, had adopted the technology.
Despite the many benefits of EHR platforms, there have been some studies which found physicians have struggled to adapt to using the software systems in a way that makes their workloads more efficient. For example, a 2014 survey conducted by the magazine Physicians Practice found that less than half - around 47 percent - of physicians believed EHRs actually made a positive difference in terms of reducing their workload.
As journalist Aubrey Westgate explained, however, writing in Physicians Practice and citing senior vice president of the Coker Group, Jeffery Daigrepont, it's unlikely that the EHRs themselves are to blame for any productivity issues that physicians are encountering. Rather, it's more likely the doctors are simply not using the platforms in the most effective way possible.
If physicians at your medical practice are struggling to use their EHRs in a way that helps expedite their workload, there are strategies that can be implemented to help remedy the problem. Some of the most effective include:
1. Using shorter notes
According to Dr. Dike Drummond, writing in an article published by the Med Job Network, physicians often spend too much time writing patient notes that are overly detailed. He stressed that all doctor notes should contain a billing code for insurers and should be comprehensive enough for other providers to understand when they take over and review the charts. He explained that making the notes also serves a legal purpose - they work as evidence in the event of malpractice claims and so on. Drummond elaborated that due to the fact that physician notes only need to satisfy these basic requirements, they don't have to be extensive or lengthy. Put another way, concision is key. If physicians are encouraged to keep their note taking to a minimum, they'll likely begin to notice that their workload is more manageable.
2. Embrace change
For some physicians, issues with EHR utilization may be attributed to attitude. As Dr. Drummond noted, medical professionals used to paper and older systems of patient management and care may not be receptive to the changes that are a corollary of EHR introduction. The most effective way for physicians to overcome this, therefore, is to adopt an open-mind and, most importantly of all, remain patient. Indeed, as argued by Rey Wuerth, Catherine Campbell and W. James King, writing in an article published by the U.S. National Library of Medicine, National Institutes of Health, doctors usually only become adept users after a period of many months, which will likely feature a number of growing pains.
3. Reaching out to the vendor
Westgate explained that most EHR vendors can be relied upon to offer guidance, assistance and education to physicians when it comes to effective EHR utilization. Vendors can offer advice on how best to use their platforms, showing doctors shortcuts, how to use templates and so on. Westgate interviewed an executive from the Medical Group Management Association Health Care Consulting Group, Rosemary Nelson, who suggested that it can also be effective for vendors to offer all day, in-office assessments of physicians and their EHR use, to determine best where improvements can be made. Speaking directly to physicians she said, "Let them observe you, let them follow you around for those 20 patients and see what it is you do over and over, and then have them help you create that shortcut abbreviation." It is important, of course, to check with your vendor as to whether such services are available. There may also be an additional cost. Furthermore, it is important to keep in mind that most vendors offer comprehensive training programs online that all doctors should be encouraged to review to improve their skills.
4. Creating templates
According to an article by Wuerth, Campbell and King, physicians are encouraged to work closely with templates for certain medical notes. While it can take a while to become comfortable with this feature at first, it can save doctors a considerable amount of time in the long-run, as they'll curtail the need for writing out notes that are overly common.
5. Delegating work
As detailed by Westgate, citing advice from Nelson, physicians can make their workday more efficient by training other staff members on the basics of EHR use to make the delegation of tasks such as basic data-entry possible. For example, nurses can handle some of the documentation work associated with caring for patients. As Dr. Drummond noted, open communication is key here - physicians shouldn't be afraid to ask for help from other team members when they feel burned-out by their EHR workload.
6. Updating regularly
According to Westgate, discussing advice from the senior clinical team lead at Regent Medical Solutions, Marsha Hopper, EHR platforms are regularly updated and improved by vendors, and the information is typically relayed to users online, via email or a portal. Physicians can help improve their EHR use if they stay abreast of these changes, which are invariably designed to improve the platform and make their lives easier.
7. Using scribes
Dr. Dike Drummond noted that one option for physicians, particularly in practices with larger budgets, is to hire scribes to assume responsibility for note taking and data-entry. The benefits of this is that it relieves substantial pressure on physicians, enabling them to see more patients. Drummond noted, however, that for many practices the cost of this solution may outweigh the gains of seeing more patients in a given day.