Almost 80 percent of U.S. doctors have switched from paper records to electronic health records (EHRs), according to recent statistics. The implementation of EHRs is now mandatory for medical practices that wish to benefit from the government’s Meaningful Use incentives. But while EHRs are supposed to streamline communication and simplify doctors’ day-to-day activities, in fact, satisfaction and productivity have dropped in many practices that use them. Why is this, and what can doctors do to make EHRs work better for them and their patients?
Does your EHR suit your specialty?
One complaint doctors have about EHRs is that one size does not fit all when it comes to medical specialties. Several years ago, the American Academy of Ophthalmology formed an IT committee to address special requirements to help EHR systems be used more “intuitively and efficiently” by ophthalmology practices. They found that many EHRs being used by ophthalmologists were “large, comprehensive systems that originally were designed for other medical specialties or large enterprises,” such as hospitals or health plans. The committee published a list of recommendations for improvement, including:
- Supporting documentation in and transitions between the office and operating room
- Capturing, tracking, and displaying “vital signs of the eye,” such as visual acuity
- Incorporating hand-drawn sketches or annotations into records
From too many fields to fill out, to excessive security measures that affect efficiency, this post by Dr. Edwin Leap explains many doctors’ frustrations with health IT in its current form. Since EHRs aren’t going anywhere, however, you’re better off figuring out how to work with them than throwing up your hands. Does your staff need more training? Do you need to evaluate your workflow processes? Here’s a look at the best practices for maximizing your EHR system’s features.
One answer to the documentation burden
Another aspect of EHRs that burdens rather than lightens the load on doctors is documentation. Many practitioners complain that EHR documentation requires too many “clicks” or keystrokes during the patient exam. And patients are also noticing when EHRs are monopolizing their doctors’ time and attention. A recent study by Northwestern University found that physicians spend one-third of their time looking at their EHR, whereas physicians using paper charts spent only 9 percent of their time looking at them. (See also: Is Technology Helping or Hurting Your Practice?)
One answer to the problem is to hire a medical scribe. Often tech-savvy college students or recent graduates interested in pursuing a career in medicine, medical scribes specialize in charting physician-patient encounters in real-time in the EHR during medical exams, leaving doctors free to focus on their patients rather than documentation. The 2014 Tech Survey published in Physicians Practice found that approximately 21 percent of physicians currently use medical scribes.
“Patient satisfaction increases when they receive a physician’s full and focused attention,” writes longtime scribe-user and physician Kathleen Myers on KevinMD.com. “In fact, studies show improvement of 40 to 45 percent in Press Ganey patient satisfaction scores to overall levels of 90 percent and higher when scribes are used.”
MU Stage 3 and patient education
Meaningful Use Stage 3 requirements focus on improving quality, safety, and efficiency, leading to improved health outcomes. This includes patient access to self-management tools. Most doctors who use EHRs agree that the included patient education materials are not the best in terms of quality and clarity. This is where a good cloud-based patient education program can help.
High-quality animations that visually explain conditions and treatments are proven to be more effective in terms of patient engagement and compliance than text-heavy printouts full of highly clinical information. Show them to the patient right in the exam room, post them on a patient portal, or with the right platform, email them directly to the patient either before or after an appointment or queue them up to play for idle patients waiting in an exam or waiting room.
There may be nothing you can do about EHRs, but with some strategizing and the right tools, you can figure out ways to work with them so that they enhance, rather than detract from, your patients’ experiences. For more information about using technology to improve your practice, subscribe to our newsletter.