Todd Shryock, contributing author
Time spent on EHR data entry instead of interacting with patients is a common complaint from doctors.
Time spent on EHR data entry instead of interacting with patients is a common complaint from doctors. Studies show that physicians spend as much time on entering information in their EHR as spending face-to-face time with patients, and it can have a direct effect on job satisfaction and contribute to burnout.
Martin Pricco, MD, MBA, an internist and president of Gould Medical Group in Modesto, Calif., did an evaluation with Paul DeChant, MD, MBA, deputy chief health officer of Simpler/IBM Watson Health, examining how Gould’s 360 physicians and allied health practitioners were spending their time in the EHR. The goal was to help the physicians become more efficient and reduce their frustration with the system. He shared his experience at the 2018 Health Information and Management Systems Society (HIMSS) conference held in Las Vegas.
Here are eight changes that can be implemented to help reduce physician frustration with the EHR.
Improve the password process. Physicians should not spend any time typing passwords into workstations in the practice. Instead, provide a proximity password device or other technology solution that does not require the physician to enter a password on a keyboard each time they enter a new room.
Attend or provide individual optimization training. “There is a high correlation between using personalization settings and physician satisfaction,” said Pricco. EHR systems often have features that allow rapid access to data or customization options that physicians don’t even know about, so investing time in training can pay off in long-term time savings and frustration reduction.
Pricco says Gould physicians needed a minimum of six hours of onboarding training, four hours in the classroom and a week of having a trainer spending one-on-one time with them. When complete, physicians can create filters, preference lists, and know how to find the data they need to deliver quality care.
“One of the most common doctor complaints is that they can’t find what they are looking for in the EHR,” Pricco says.
It’s also important to stay current with software upgrades and the training to take advantage of new features.
Know where time is being wasted. Most EHRs have charts that can show exactly where physician time is being spent in the software. If there are multiple physicians in a practice, compare these results and see if someone is more (or less) efficient than everyone else. Share best practices to improve everyone’s efficiency. These charts are also a good way to measure the effect of training or other changes.
Customize the EHR to workflow and specialty. The out-of-the-box desktop view from the EHR vendor may not have information organized in a way that helps a physician find what he or she needs and there are often tabs or other information they do not need. Take the time to customize the view for each physician in a way that suits them best. At Gould, there was a high correlation between customization of the EHR and physician satisfaction.
Find the documentation time-saving method that works best for each physician. At Gould, physicians create notes in the EHR through a variety of methods: 27 percent use voice recognition, 10 percent dictation, 7 percent scribes, 33 percent use templates, 4 percent use remote scribes, and 21 percent use some combination of the above.
Pricco says the important point is that every physician works differently and it’s important to find the way that each physician is most comfortable with and make it available.
Create a review process. Physicians often waste too much time reviewing or approving items that could have been handled by someone else with a lower licensure level. Create a system where all “in basket” items are reviewed by a member of the staff before they are sent to a physician. Items that don’t require physician input can be rerouted to the appropriate person.
Create a centralized prescription refill plan. Where possible and allowed by law, have staff RNs or other licensed clinicians handle mundane prescription refills.
Install a printer in each exam room. If physicians are spending time walking back and forth printing out information from the EHR, consider installing a printer in each exam room. The cost of a printer is far less than the doctor’s time.