Physicians are reporting high rates of burnout, which studies suggest can affect patient safety. This can be partially attributed to the administrative burden placed on physicians, who frequently lose clinical hours to EHR tasks.
Simplifying physicians' workflow with more effective systems can reduce stress levels and improve care outcomes, research shows.
Cutting red tape
EHRs are not living up to their potential, according to a researcher from the University of Missouri in Columbia.
Often, new providers struggle to find patient records when they are transferred from hospitals. This leads to repeat testing and paperwork — and wasted time — for patients and providers, according to a Sept. 20 article on the university's website.
Further, EHRs are expensive, difficult to train personnel on and difficult to update, said Kate Trout, PhD, an assistant professor at the university's health professions school and lead author on a study examining EHR utilization.
Dr. Trout's study, published in April in the Journal for Healthcare Equality, analyzed the correlation between full EHR utilization and patient mortality rates in 300 hospitals and more than 5 million patients.
Dr. Trout found hospitals that meet federal "meaningful use" criteria — utilizing EHRs in a way that promotes information sharing, public health reporting and interoperability — improve patient care quality and reduce patient mortality to a greater extent than those that do not.
"With this information, are there alerts we can put in after a surgery to ensure we follow up at critical points in time? Are there certain patient populations that we can use the data to catch them earlier and make sure we give them extra care and not just put them through the same routine protocols as everyone else?" Dr. Trout asked in the article, indicating more can be done to improve EHR systems.
Clicks add up for providers
After moving from Chicago-based Northwestern Medicine to Rush University Medical Center, also in Chicago, Daniel Dunham, MD, an internist, identified an issue with Rush's EHR that cost him about an hour each week.
Unlike Northwestern, Rush's system required Dr. Dunham to re-enter his login credentials each time he sent a prescription. This added 10 minutes to his workday, he told the AMA in a Sept. 13 article on the organization's website.
"If we can try to minimize the time that we spend away from direct patient care, it’s going to help eliminate our frustrations; but it’s also going to let us optimize our time with patients where our time is probably best spent," said Dr. Dunham, who helped implement the change in Rush's system.
Closing care gaps
"Burdensome documentation" practices were detracting from patient care, according to a recent case study at Indianapolis-based Community Health Network.
When those processes were reduced in the system's EHR, the network closed 373,000 care gaps in six months, according to Patrick McGill, MD, a practicing family physician and executive vice president and chief transformation officer of Community Health Network.
Community Health Network utilized the application Health Catalyst Embedded Care Gaps, an EHR-embedded solution that populates agendas and actionable procedures for each patient visit. This decreases time spent searching for data, as well as clicks required to place orders and document care, according to the case study.
Inefficiency is a driver of burnout that extends to all caregivers, from physicians to medical assistants to nurses, Dr. McGill told Becker's. By utilizing Health Catalyst, the system addressed care gaps across the board without piling extra labor on overwhelmed providers.
"Leveraging the Health Catalyst platform, we saw an opportunity to put the care gap information back into the medical record at their fingertips so that when they are seeing a patient, they know exactly what care gaps need to be closed," Dr. McGill said. "They are not searching through the chart to find information."
Health Catalyst eliminated "thousands of hours of manual data review" and improved efficiency and productivity by 25 percent to 30 percent, a spokesperson from the platform told Becker's.
"It's really the right information, at the right time, at the right part of the workflow that basically makes it seamless and easy to do their job," Dr. McGill said.
The network also improves efficiency with training and education in EMR workflow, virtual scribes and "tap in, tap out" functionality so providers do not have to type in passwords, he said.