EHRs and the entire implementation process loom large in the minds of healthcare administrators and physicians. Not to mention the ambiguous "optimization" phase. Though the majority of health systems now use electronic records, switching EHRs, updating or consolidating to a single model after an acquisition or merger can renew the frustrations stakeholders dealt with initially. It's not difficult to understand why, for all of their promise, EHRs are often viewed as a burden rather than an asset.
"How the EHR, which was in part meant to liberate physicians from the drudgery of paperwork, instead became their chief oppressor is a long and complicated story," Jeff Butler, founder and CEO of Privia Health, and John Fox, executive director of content at athenahealth, wrote in a post on the Harvard Business Review.
Since turning back to paper records is out of the question, here are five steps and questions the authors suggest using to look at the EHR problem from a more helpful angle, according to their Harvard Business Review post.
1. Define "the why." When in the trenches of an EHR implementation or switch, it can be easy to lose sight of the justification for all of the resource investment that goes along with such a change. Physicians know that adjusting to a streamlined clinical workflow will improve quality of care and adopting a common technology platform is essentially for doing just that. During the growing pains phase of an EHR project, make an effort to ensure that stakeholders at all levels understand the greater purpose of the initiative and that the concessions they're making are for good reason.
2. Help physicians focus on doctoring. Research shows employees who are able to focus on a single task while working are significantly more engaged in their work. This is a particularly worrisome finding for physicians, who spend a significant chunk of their time balancing EHR-related tasks and patient care. "For an EHR to become a tool for physician engagement, it needs to wick away work from physicians so they can focus on patients," the authors of the HBR post wrote. Taking advantage of workflows built into EHRs that mitigate the amount of tasks falling on physicians frees up their time and focus for patients and creates an environment with fewer distractions.
3. Get visibility down to the mouse-click. Measuring EHR usage down to the micro level, such as the mouse clicks physicians make as they navigate the systems, allows for the quantification of numerous important metrics. It also gives perspective on how different workflow areas in a single system are functioning with one another. EHRs can provide valuable insights if their innate features are capitalized on. This data can enable leaders to intervene early with staff when an area for improvement becomes apparent, the authors wrote.
4. Create a performance "game layer." Providing EHR users with feedback based on their own performance can create a gamification effect, where physicians and other clinical staff seek to improve just by having an baseline understanding of their current performance. For many clinicians, EHRs provide the first-ever opportunity for this type of real-time feedback.
5. Reward outcomes, not effort. A shifting emphasis toward fee-for-performance based on outcomes is bolstered by the outcome-tracking capabilities of EHRs. As EHRs provide systems with the tools to track patients across the care continuum, savings can be offered as a reward to physicians, another opportunity that would not have been possible without EHRs.