3 Ways to rebound efficiency after EHR implementation
The promise of implementing an Electronic Health Record (EHR) system to make healthcare cheaper and more efficient has eluded most practices. A quick Google search on the term “EMR or EHR issues” will reveal a myriad of problems associated with doctors and clinicians using EHR systems. In fact, EHR adoption and usage is partially to blame for an uptick in physician burnout.
OSU Wexner Medical Center’s Donald Mack MD suggested that EHR usage along with value based care has augmented physician burnout. In a response to a recent study Dr. Mack stated, “[Physician]Burnout is associated with lower patient satisfaction and care quality, higher medical error rates and malpractice risk, higher physician and staff turnover, physician substance abuse/addiction, and physician suicide.”
Not at all what was sold to physicians.Physician Burnout is associated with lower patient satisfaction and care quality, higher medical error rates and malpractice risk, higher physician and staff turnover, physician substance abuse/addiction, and physician suicide.” Click To Tweet
Although physicians may feel that they work more for their practice administrator than their patients, implementing and using an EHR effects the entire practice’s efficiency, from scheduling to checkout to patient care to employee satisfaction. The same promise of a “Global medical record” was made to consumers who now end up filling out new patient paperwork at home and then end up doing it again in the waiting room, at which point a staff member enters it again into a system. For consumers this happens with every new provider they see.
Although it’s difficult to compare apples to apples when discussing the old way of doing things vs electronic ways, one thing is for sure there is a definite need for improving the latter.
1. Sharing data between systems
Where we focus a large part of efforts for clients is connecting disparate systems. Industry terminology calls it “System Integration“. In other words, we connect computer systems and software with our telltaleo™ platform so that data can be passed back and forth and shared between two or more systems. This reduces hours of duplicate entry and the possibility of human input error.
Many practices have a marketing team who do field/referral marketing or a call center that speaks directly with prospective patients. These job functions typically do not have access to clinical systems. In situations such as this a practice may have a customer relationship management system (CRM), such as Salesforce, Infusionsoft or ZOHO (or use email or excel) where they keep track of and manage their referral sources, prospects & tasks. Additionally, analytical data from the web, clinical PACS & Lab systems oftentimes lives on its own in stand alone systems, spreadsheets and/or emails.
Office staff end up entering patient information into multiple systems:
- CRM, Email or Excel (even on post-it notes)
- Benefits verification portal (VOB) such as Availity
- Into a schedule, hopefully in a practice management or EHR system
- Into a PACS in the case of digital imaging
- Telemedicine systems
- Patient portals
- Into a testing lab systems
I’m sure there are more systems that I missed, but this should give you a sense of the amount of duplicate data entry that takes place on a daily basis. You can see how connecting a few of these systems together could save hours of time each day on data entry and reduce the human error factor (not to mention data integrity issues).
Adding up system inefficiencies
As a conservative estimate, if your practice saw 100 new patients each month and spent 15 extra minutes per patient entering the same data twice you’d be looking at 25 hours of time wasted every month on just data entry.
It doesn’t take long to figure out that those 25 extra hours would produce a much better return on investment if the time were used for seeing patients.if your practice saw 100 new patients each month and spent 15 extra minutes per patient entering the same data twice you’d be looking at 25 hours of time wasted every month on just data entry. Click To Tweet
2. Hiring a scribe
Physicians who spend several hours per day on administrative tasks may find that hiring a scribe to assist with EMR/EHR tasks is cost effective and stress relieving.
A medical scribe is trained to enter patient information on behalf of a physician while taking direction from the physician. Scribes are often medical students, medical or physician assistants, nurses or nursing students. They follow a physician into the exam room and record the patient history, the examination and treatment plan, as dictated by the doctor.
This allows physicians to interact more with their patients and save time with data entry. Simply stated, scribes help doctors so doctors can help patients.
Some of the downsides to hiring a scribe include: training both scribes and the physicians to work together, investing in additional staff, and high turnover due to the nature of the job (especially is medical students are used).
3. Training & retraining users
When electronic health record systems are implemented, if done properly, users spend weeks and even months learning & practicing how to go from their old system and processes to new ones. Users learn how to interact with a system that the practice is now highly dependent upon.
One of the main issues that needs attention during an implementation is being aware not to overwhelm an already busy staff with a new system. Some EHR companies will try to push too much responsibility on staff or an overzealous manager underestimates the complexity of implementing a new system. This is why EHR software companies look internally for “Super users” who are tech savvy and excited about the new system. Super users help train the rest of the staff and a key component of “successful” implementations.
Another important approach during implementation training is to only train staff on their job function within the system. This will cut down on overwhelming staff with a potentially complex system. For example, scheduling should only learn how to schedule, there’s no need to train them on the billing function. At least not at the outset.
Most any software implementation will run into snags along the way. By conducting post implementation feedback sessions staff will have the opportunity for training concepts to be reinforced. If there are misunderstandings, confusion about system usage or bottlenecks that have popped up they can be uncovered and addressed during feedback sessions.
Finally, people will be trained and leave for different jobs, new staff will take their place. It’s important not to overlook new employee onboarding in relation to EHR training. Make sure to discuss this with your EHR company and have a plan in place when new employees join your team.
Having an efficiently run practice takes a lot of work and planning. EHR/EMR systems promised to make practices more efficient and allow physicians to spend more time with patients. Unfortunately in many cases the opposite happened. By integrating disparate systems, utilizing scribes and creating a comprehensive EHR training program a practice may actually become more efficient and allow physicians to get back to what they are passionate about: Helping Patients.