STRAIGHT TALK
TY GLUCKMAN, MD
Make Your EHR Work for You
W
e all know that electronic health record (EHR)/electronic medical record
(EMR) systems are ubiquitous, largely
because of the federal EHR Incentive Program
and efforts to be compliant with requirements
defined by Meaningful Use. While EHRs/EMRs
offer improved access to patient data, improved
opportunities to deliver better preventative health
care and more robust methods to record charges,
innumerable challenges have come about with
their implementation.
A 2014 survey of nearly 1,000 physicians
confirms the challenges. Forty-two percent of
survey participants said that the ability of their
EHR to improve efficiency was difficult or very
difficult; 43% felt that they had yet to overcome
productivity challenges related to their EHR; 72%
expressed that the ability of the EHR to decrease
workload was difficult or very difficult; and 54%
said that their EHR had increased their total
operating costs.
While there are countless frustrations with
EHRs/EMRs, they are here to stay. That means
we need to ensure our systems work for us, as
opposed to against us. Improving workflows is
at the top of the list for ensuring success. A deep
dive is often required within one’s practice, hospital or health system to understand whether workflows related to the EHR/EMR can be optimized.
As we all struggle to navigate the EHR landscape, my biggest piece of advice is to avoid trying
to figure this out all on your own. Brainstorm with
everyone in your office or hospital. All members of
the care team have good ideas—they are very aware
of what’s slowing them down and often have good
ideas about what can be done to fix the problem.
Reach out to peers both in and outside of your
office, hospital or health system to figure out what
has worked for them (and what hasn’t worked for
them). And don’t forget to take small steps—often a
series of small steps make a big difference.
This advice applies across the board. However,
everyone has different struggles when it comes to
effectively using an EHR/EMR.
If your core issue with EHRs is related to
knowledge or use of existing tools, focus on
training, optimize your desktop, develop tips and
tricks that can be shared with the entire care
team, create preference lists (shortcuts), build
documentation templates, and explore use of
voice recognition software and scribes.
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Are you having problems related to clinic
operations? Often, an EHR/EMR implementation
uncovers and magnifies inefficiencies in clinic
operations and variations that may exist. Try to
avoid schedule conflicts, set aside time for catch
up and phone calls, staff adequately for rooming
patients and fielding patient calls, and work to
minimize patients arriving late.
Is the problem related to care team activities?
Make sure outside records are available, strongly
consider chart abstraction in advance of visits,
maximize use of patient portals, share in-box/
in-basket responsibilities, and consider shared
documentation.
You should also consider if your issues stem
from your own habits. Be sure to start on time,
review available records in advance, document as
much as possible in real-time, close all ambulatory
encounters the same day, and route your notes.
Finally, you should utilize your EHR/EMR to
drive