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Improving EHR usability requires focusing on four core areas


By focusing on these four core areas, healthcare organizations can substantially improve the usability of their existing EHRs.

As noted in a recently published paper in the Journal of the American Medical Informatics Association, EHR usability is a major hurdle for healthcare organizations after implementation. Despite federal requirements promoting a user-centered design approach to development and testing, clinicians struggle with the usability of their EHRs, even after facility-specific configuration, customization, and training.

The paper is just the latest study to look at problems with EHR usability, which are known to fuel clinician burnout, increase clinical errors, and lead to patient safety issues. Physician burnout has reached epidemic levels, doubling the odds of unsafe patient care, unprofessional behaviors, and low patient satisfaction, and driving higher levels of physician attrition and depression.

Because EHR usability directly impacts clinician and patient satisfaction and healthcare outcomes, healthcare leaders must prioritize initiatives that improve the user experience. In particular, stakeholders should consider EHR usability improvements in these four core areas:

Improving patient care

Few EHRs were designed to enhance patient care – or even meet the needs of clinicians. Instead, EHRs were created to help billers and coders get the information they required to perform their jobs. Rather than dedicating themselves to the delivery of high-quality patient care, clinicians have been performing burnout-inducing data entry tasks that serve the needs of financial teams.

To enhance patient care, leaders must implement tools that allow clinicians to focus on serving patients. Adding technologies that work behind the scenes to capture and interpret the billing and coding details from clinical documentation can minimize burnout and enhance patient safety and satisfaction.

Streamlined workflows make it easier for clinicians to quickly find the patient- and problem- specific information they need to drive better outcomes. To empower clinicians with the right information, EHRs need technologies that can review everything in the chart, intelligently filter the information in real-time, identify all the potentially relevant data points, and deliver pertinent details in a single view.

When it is easier for clinicians to access critical patient information, physicians are less frustrated, burnout risk is minimized, and patient safety is enhanced.

Increasing physician productivity

Physician productivity – and satisfaction – is enhanced when clinicians can easily access the information they need, when they need it. Too often physicians are flooded with so much clinical data that they waste significant time sifting through the chart to find relevant details.

Clinicians need workflows that support the automatic identification and interpretation of the disorganized and complex array of medical information from previous encounters, lab reports, inpatient records and other sources. Clinicians are served pertinent information, saving them time and allowing them to focus on the patient instead of their computers.

Clinician productivity is further enhanced when the computer does not disrupt the ways clinicians think and work. “Enhancements” that are designed to make clinical decisions on behalf of physicians can make EHRs less useable because they interfere with clinical workflows and rarely tell a physician what he or she does not already know. To preserve productivity, clinical workflows should replicate–not change—the way physicians deliver care.

Ensuring accurate reimbursement

To minimize data entry and ensure appropriate information is captured for accurate reimbursement, EHRs need technologies that work in the background to verify billing, compliance, coding and quality measurement.

For example, organizations participating in Medicare Advantage and other risk-bearing reimbursement programs require accurate documentation to support Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores, which are used to estimate patient care expenses and calculate provider reimbursement. To ensure accurate payments, providers must fully and accurately capture a patient’s condition on an annual basis, including complete and specific documentation for all of a patient’s qualifying diagnoses.

Traditionally, providers have mostly relied on retrospective, manual chart reviews to identify possible documentation and coding gaps. When gaps are identified, patients are typically requested to return to the office for a follow-up visit – which, at a minimum, is inconvenient for both the patient and the clinician.

Instead of inefficient and error-prone manual methods, organizations can implement technologies that prompt physicians at the point of care when patients have potentially eligible HCC conditions. Physicians can then immediately address any treatment, documentation, or coding gaps while patients are still in the exam room. This results in more accurate documentation and coding–and ensures accurate reimbursement.

Reducing operational expenses

Adding tools that enhance clinician productivity and streamline documentation, coding and billing processes can help organizations reduce their operational expenses. For example, if clinicians have documentation tools that support the quick and efficient capture of visit information at the point of care, transcription needs can be reduced or eliminated.

Technologies that automate manual processes can further reduce operational expenses and increase efficiency and accuracy. EHRs should be equipped to automatically capture and interpret billing and coding details from clinical documentation to reduce the need for manual chart reviews. Organizations can further reduce manual efforts if the EHR provides ready access to high-quality data for queries and reporting in support of value-based care programs, including population health management initiatives.

By focusing on these four core areas, healthcare organizations can substantially improve the usability of their existing EHRs – and enhance clinician satisfaction and patient outcomes.

David Lareau is chief executive officer of Medicomp Systems, which provides physician-driven, point-of-care solutions forEHRs.

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