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What You Can Do to Optimize your EHR

If you expected your EHR to provide a big and immediate boost in efficiency and productivity, chances are you’ve been disappointed — maybe even devastated. Many say the opposite has happened. They’re spending more time to get less done.

But take heart. There’s likely a reason, and there’s hope.

First, the reason: You may be experiencing what’s known as the “productivity paradox” of information technology. The idea is that those who adopt new information technology tend to expect rapid improvements. But the reality is that the benefits of such technology typically come about much more gradually, and they may be preceded by an initial downturn. Robert Wachter, MD, chair of the Department of Medicine at the University of California-San Francisco, thinks that’s what’s happening with EHRs, and that profound improvements in productivity may not materialize for several years.

It makes sense that disruptive technology takes time to assimilate, but the good news is that we don’t have to sit around and wait for things to get better. There are steps you can take now to get more comfortable with, and get more out of, your EHR. Here are 6 tips:

Take full advantage of what your vendor has to offer

One of the biggest mistakes providers make, says Heather Haugen, VP of Healthcare Provider Solutions at Conduent, is to think they’re done with training the moment they go live. EHRs are complex and take a long time to master, she points out. If your users are struggling or frustrated, ask your vendor to spend a day observing how they use the system. See if they can help create shortcuts and illuminate the bigger picture once they know your patterns. It will cost a little more, but the boost in productivity will likely be well worth the expense.

Be sure to use patient portals

Portals can eliminate a large number of tasks that otherwise require big chunks of time for staff and physicians. Patients can use them to schedule and cancel appointments, request refills, ask questions, view lab results and enter health histories and current medications — information that can then be seamlessly pulled into your EHR. Just make sure patients understand that answers to questions may not be delivered for 24 to 48 hours, so urgent matters should be addressed elsewhere. Patients also appreciate the privacy that portals allow, as opposed to, say, having to answer questions on the phone within earshot of others.

Continually reevaluate your workflow and processes

Assuming your workflow is well mapped out, your EHR should be compatible with it. If it isn’t, one or the other needs to change. That may involve changing templates or making other adjustments that improve efficiency.

Take advantage of “super-users” and experts

Every office has them. Capitalize on the experience, expertise and intuitive nature of your computer whizzes by encouraging others to work with them, and them to work with others. Providers who know just enough to get by will be delighted to learn time-saving tools and shortcuts.

Spread the word about user groups, too. “People are always posting how they do things,” says Rosemarie Nelson, of the MGMA healthcare consulting group. “Maybe they even built a template that they’ll share with you.”

If possible, spend time with a similar medical practice that’s using the same EHR you have. See how they’ve overcome similar challenges and maybe even work together to help each other.

Get physicians to the table

Easier said than done, but crucial when it comes to EHR optimization, says Dr. David Butler, a physician informaticist and former Epic Systems physician of the year for EHR implementation, optimization and transformation.

To improve your chances of getting physicians to take part in meetings or provide feedback, Dr. Butler suggests contacting them via email, so they can respond at their convenience; using images to ask, for example, which design of a particular screen they prefer; using screencasts or short videos to explain proposed changes and solicit feedback; and/or using SurveyMonkey with embedded images and multiple-choice questions.

Whatever it takes, says Ms. Haugen: “It’s very important that leaders and clinicians continue to prioritize optimizing workflows, improving overall processes and ensuring the change that’s needed happens.”

Get staff and/or scribes more involved

You can free up precious physician time by delegating certain tasks to staff or others. Should physicians be tapping away in exam rooms, taking down patient health histories? Nurses, front-desk staff or scribes can do the job as well or better if they’re properly trained. In fact, scribes undergo extensive training to be able to handle precisely such tasks.

Scribes are also gaining traction for physicians who type slowly or poorly, says management consultant Elizabeth Woodcock, whose research shows that the gain in productivity and physician satisfaction brought about by scribes typically outweighs the additional expense.

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