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In our last last article about EHR optimization, we looked at a case study from La Rabida Children's Hospital in Chicago; this week, we consider physician satisfaction with EHRs and some best practices for implementation.

It's no surprise that a recent study conducted by The Physicians Foundation showed that 81% of physicians feel overextended by patient load; the survey of 20,000 providers also showed that ICD-10 demands, EHR implementation and Meaningful Use standards are also major stresses.

While the vast majority – 85% – have implemented EHR (electronic health records), only about a quarter (24%) believe that digitalization has improved their efficiency. Forty-seven percent added that EHRs detract from positive interactions with patients.

In fact, despite their growing use, EHRs have not yet fulfilled their potential for improving the nation's healthcare. "Evidence suggests that current approaches to EHR use are not generating real value for the healthcare system. This raises the critically important question: What else do we need to do ... to produce real, near-term performance improvement in the delivery of healthcare?", according to the progress report on EHR adoption and use issued jointly by the Robert Wood Johnson Foundation, Mathematica Policy Research, the Harvard School of Public Health and the University of Michigan's School of Information.

Physicians that move into the world of EHRs are reminiscent of when Dorothy entered Oz, going from a black & white world into color, says Steve Baker, president of Eyefinity, part of VSP Global, the country's largest HMO.

"Moving from paper charts to EHR technologies is a very different world indeed, one that has new and strange things much like what Dorothy experienced," says Baker, who still calls EHR a great "disruptive opportunity," one that can help the industry to advance systems interoperability, reinvigorate business and ultimately enhance the patient relationship.

Baker says that once a physician has adopted the basics of EHR, then new areas to optimize in their business become clear, including smart efficient coding, graphically managing patient outcomes and engaging consumers through a patient portal. "EHR helps accomplish two critical objectives: help your practice operate more efficiently and engage with your customer (the patient!) electronically."

He recommends that workflow needs be prioritized by thinking about the common repetitive tasks done in the office every day. In the world of optometry, for example, clinicians check in patients, route patients from pre-test through the exam and then into the dispensary where the transition from medical to retail takes place.

"A practice can initiate time-tracking studies to understand where the points of inefficiencies are. These areas will be leading indicators of where to prioritize your improvements. Observing practice operation and clinical flow and can allow subtle but powerful adjustments to help the practice operate more efficiently."

Other EHR optimization tips from Baker include:

  • Under the old adage of you can't improve what you don't measure, it is important for practices to have some level of measurement reporting. When possible, use a simple "dashboard" of Key Performance Indicators (KPI) so a practice can watch its performance over time. More advanced practices augment with their own KPIs or use third-party firms that offer sophisticated KPI tracking and modeling packages. Pull your staff together, and ask each person for one recommendation of what to measure in the practice. You might be pleasantly surprised with what your team comes up with.
  • Make sure you understand the requirements of Meaningful Use and that your systems are set to manage these requirements. Consider designating a Meaningful Use point person who understands the regulations, deadlines and incentive requirements.
  • Be the leader of your practice, not of your information technology – outsource and get current technology in place.
Last modified on Sunday, 21 September 2014
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