Providers and clinicians will be challenged with increased data entry demands to meet Meaningful Use Phase 2 regulatory requirements. Time spent entering data into the electronic health record (EHR) may result in increased wait time for patients, less time spent providing clinical care, decreased patient satisfaction and expenditures on personnel to assist with data entry.
A well-designed EHR can decrease these burdens and actually lessen documentation time in addition to the obvious benefits of data portability and patient safety. Increased regulatory requirements for health care providers will challenge IT staff and vendors to provide solutions to meet these demands.
Sites that follow the below guidelines on implementation and maintenance of the EHR seem to have less provider and clinical frustration and dissatisfaction, resulting in better EHR adoption, improved quality of care, and higher levels of patient satisfaction. The following are some examples of activities that should be addressed during EHR design and optimization to ensure productivity during and post go-live:
1.Vendor tools such as favorites, order sets and templates should be readily available and dynamic. Changes to formulary, documentation requirements, or medical practice standards should be communicated to IT by user liaisons or advisory boards well ahead of implementation and incorporated into these tools.
2. Use of alerts, warnings, advisories and hard stops should be very limited. The more these are used, the less effective they become. Providers are counting each click to bypass these items. Alerts must provide meaning and value to the user!
3. Use default responses where appropriate. For example, if 80% of patients need a wheelchair to go to Radiology, make that pre-selected if your system permits. Still counting those clicks…
4. Follow-up initial training to make sure providers are taking advantage of vendor-supplied customization tools and other shortcuts. Providers may have mastered the basics required to enter an order, but may be reluctant to seek help for things that might make entering that order easier. Habits are established quickly; organizations should take advantage of the learning curve to ensure users are aware of the full-scope of possibilities. This pertains not only to those entering information into the system, but also to those who primarily view data contained within the system.
5. Changes or upgrades should be done on a predictable schedule, with ample communication and clinician collaboration. No one likes surprises in the EHR, and changes to the EHR should not be taken as” matter-of-fact” as a change to social media pages. Providers and clinicians should participate in testing if possible – they have found shortcuts and workarounds you are not aware of that may be lost by system changes, impacting workflow and decreasing productivity.