Overcoming Electronic Health Records Frustration
Electronic health records are frustrating already overwhelmed healthcare professionals nationwide. EHRs are expensive and time consuming; often decrease efficiency and, in many cases, are counterintuitive in their function. They also open a completely new, 21st Century set of patient safety and privacy risks.
A recent survey conducted by the American College of Physicians shows that healthcare provider frustration is only increasing as larger numbers implement EHRs into their daily practice of medicine. According to the survey, EHR-user satisfaction has fallen 12 percent since 2010, and those who are “very dissatisfied” increased by 10 percent during the same time period. A major complaint among the healthcare community has been that they had hoped EHRs would help increase productivity, but have instead diminished the number of patients they can see in a day. Thirty-two percent of survey responders report they have yet to return to pre-EHR implementation productivity, up from 20 percent in 2010.
More troubling is a recent report to the Agency of Healthcare Research & Quality that projects when EHRs are fully adopted in 2015—as mandated by the Health Information Technology for Economic & Clinical Health (HITECH) Act of 2009—they could be linked to as many as 60,000 adverse medical events a year.
Provider skepticism and potential patient safety risks notwithstanding, those medical practices that cannot demonstrate EHR meaningful use by 2015 will have their Medicare reimbursement rates diminished by one percent. This penalty will increase to two percent in 2016 and three percent in 2017.
Following are three tips from physician practices and healthcare networks that have helped their providers adapt more smoothly to electronic record keeping.
• Get the entire practice onboard from the planning stages. Across almost all industries, information technology projects have a high-failure rate, largely due to inadequate “change management.” Because the institution of an EHR system will likely alter the professional duties for every staff member, the process can cause a practice-wide anxiety. Communication among all staff members is essential in ensuring that the enterprise goals translate into properly sequenced implementation actions. Establishing protocol for staff feedback is essential to tracking progress and negotiating roadblocks.
• Train and retrain. Take full advantage of your EHR vendor’s available training programs. One New York health network with 12 locations and more than 100 providers had their EHR vendor conduct a four-hour class prior to going live with the system. Several months later, the network felt their team had not completely absorbed the training, and had the vendor back for an additional two-hour training session. The network now has quarterly peer sessions where the physicians most capable with the EHR system share useful techniques and shortcuts with the rest of the team.
• Completely cease paper-based workflow. Once the shift to an EHR is complete, some frustrated healthcare providers will engage in paper-based workarounds. Paper-based workarounds include actions like writing patient data on paper to be entered into the EHR at a later time or writing sticky notes about a test result to have easy access to in an exam. Both of these actions open the risk that something will be left out of the official EHR or the healthcare provider will be using outdated information. This also hinders the provider’s acclimation to an entirely digital record system.
Has your practice achieved EHR meaningful use? If so, what were the stumbling blocks to getting there? And if not, do you have a plan in place to get there before the Medicare penalties kick in?