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In late 2020, Medical Economics® asked our physician audience what they thought would be the most challenging issues they will face this year. This is what they told us.
Electronic health record (EHR) systems remain a primary physician frustration. While the vendor market has matured, there is still a massive usability gap between what physicians want their systems to do and what their systems are capable of.
According to the 2020 Medical Economics® Technology Survey, about 70% of physicians have used the same EHR for more than five years and 71% say they have no plans to switch EHRs in the next year.
At the same time, physicians still feel EHRs leave them wanting. When asked in the survey about their primary complaints about the systems, 38% said they wanted a system that was easier to use and 33% said they wanted improved customization options.
“Frankly, I’ve never talked to a physician who said, ‘Boy, I just can’t wait to get on my EHR in the morning,’” says Rob Tennant, director of health information technology policy, Medical Group Management Association. “They understand their functionality, their utility, they know how important they are. They know, in some form, the capabilities that these software programs have, but they’re just not intuitive.”
Still, there remain effective ways physicians can reap more benefits from their existing systems, by optimizing them to improve practice efficiency and support physician workflow, says Mary O’Brien, FACHE, national practice director for Patina Solutions, a professional services organization in Chicago.
Here are four tips physicians should keep in mind.
Appoint a champion
Physician practices and hospitals should appoint what she calls a physician champion whose role is to support improvement in the utilization of the EHR through education, advocacy and training.
“There needs to be physician involvement in the design of workflows, in the design of how clinical decisions can be made,” O’Brien says. “Physicians always have to be talking to their administration about staying up to date on what their EHR’s highest capabilities are.”
This person can advocate for some key strategies to improve physician utilization and satisfaction of their EHR.
The physician champion will want to begin by making sure the EHR’s settings are personalized to the physicians using it.
“It’s very important that physicians can decide on their own what kind of alerts they want, what kind of education can come up next to some documentation or order they’re putting in,” she says.
Ideally, O’Brien says, physicians also have within their practice or hospital what she calls a clinical informaticist, someone whose role it is to make sure the information available in the EHR is actually used by the physician in the care of a patient.As an example she refers to an epidemiologist caring for a patient with diabetes. “The EHR needs to be capable of bringing up a patient’s past glucose level or past clinical visit.”
This is where those personalized settings are especially key.
Not every practice will have such a person on staff, however, so for smaller practices or private practices, she recommends partnering with other physician groups or large hospital systems or health plans to share services.
Add automated documentation tools
Next, she says, physicians should learn how to use the automated documentation tools within their EHR, such as text messages and voice-to-text dictation tools for documentation, which can include mobile device documentation tools.
These tools can reduce the amount of time the physician spends facing the computer instead of the patient, limiting the need for a scribe.
Lastly, O’Brien emphasizes that no number of tools will make an EHR more useful without training, O’Brien says. And given how frequently CMS updates rules and regulations for EHRs, such as Meaningful Use and Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), it’s equally important that physicians have training resources available to them at all times to keep their knowledge and education about their EHR up to speed.
While most EHR companies put out regular addenda when new rules are released, she says it’s better to have someone who can stay on top of these changes just in case.
“All these new regulations require physicians to be trained constantly in how to use the technology to provide those metrics to the appropriate organization.
"Constant training of physicians is very important,” she says.