Keith Loria is a contributing writer to Medical Economics.
Why physicians must have a role in transforming and selecting their EHRs
An inefficient EHR can be a huge time waster for physicians. The overall usability of an EHR also is a contributor to physician career satisfaction; and when physicians have a choice as to where they practice, a provider organization wants to be on the right side of the EHR usability divide, so that technology contributes positively to physician affinity and engagement.
That’s why Christopher Maiona, MD, chief medical officer for PatientKeeper, a Waltham, Mass.-based company which provides financial applications to streamline physician workflow, says an efficient EHR is vital because it contributes to effective and timely patient care.
“An effective EHR is important because electronic patient data is ubiquitous. For physicians to put that data to use in service to patient care, they need an EHR that streamlines-rather than impedes-their clinical workflow,” he says. “Computerization is supposed to improve efficiency and productivity; ironically, healthcare is the only industry in which that has not happened, which is why EHR optimization is such a hot topic in health IT today.”
Furthermore, he says every medical practice’s goal should be to make EHRs an indispensable tool so physicians can deliver optimal patient care, which starts with improving EHR usability.
“In the mind of a physician, EHR usability refers to accessing and acting on patient information with ease,” he says. “It’s having data presented in a manner that is consistent with the physician’s unique thought process and workflow, and that allows them to intuitively act on that information on the fly.”
The problem is doctors can’t do it on their own. Health IT vendors and provider organizations must play a role in bringing strong and useful EHRs to the forefront. However, he notes, physicians can and should contribute to the transformation.
Nearly 60 percent of physicians say they did not have any input in the system they are currently using for patient care. In Maiona’s opinion, that’s not the recipe for success and much more physician engagement in EHR design and selection is essential.
“Physicians should look to add a mobile component to the EHR,” he says. “When a doctor’s smartphone and tablet can be used as a clinical tool- for example, to show patients their test results at the bedside, or to enter orders on the fly-patient care, team communication, and physician workflow benefit significantly.”
Maiona says a well-designed clinician-facing IT system can give physicians the time back they require in order to provide better care and spend more time engaging with their patients.
“A well-designed clinician-facing IT system minimizes the number of clicks, taps and swipes required to execute a routine task, like placing an order, writing a note, or entering a charge,” he says. “When you multiply that time savings, even if it’s only a minute or two per task, by the number of times each day a clinician performs that task, it can total several hours per day.”
For many physicians, that extra screen time comes at the expense of time with patients and what ought to be a provider’s personal time, at home at night. It’s an unsustainable dynamic that contributes to physician frustration and burn-out.
Many physicians mistakenly assume that an EHR should simply mimic their familiar paper processes and that has causes many of the problems that are associated with EHR today.
Maiona says that physicians need to understand that a computer has inherent capabilities far greater than paper, so it stands to reason there would be some differences.
“However, the EHR should not require physicians to re-learn how they practice medicine, nor should it put up roadblocks in the form of too many meaningless alerts,” he says. “Those are the types of things that drive physicians crazy and can frustrate them no end.”