Slow-Running EHR? Tips to Help Speed Up Your System.

Reid Dejonge Electronic Health Records (EHR)

Poor system performance and a slow EHR can impact patient care, contribute to physician frustration, and destroy practice culture. Before your medical practice throws in the towel with your EHR, gets frustrated with your EHR vendor, or wastes practice resources chasing down the wrong solution, there are a few things you can do do increase the speed of your EHR.

How to Handle A Slow EHR System

If a medical practice notices that EHR usage is slowing down their overall system, the first step is to determine who is responsible for handling the necessary “fix.” There could be a variety of responsible parties for the EHR slowness, and it is not uncommon that these parties will have to work together to resolve the issue.

Here are a few reasons your EHR could be slowing down and who to engage in each scenario:

1. Old/Outdated Hardware

Laptops, desktops, and routers that do not meet the minimum specifications of the EMR can slow down your EHR.

Responsible Party: IT Manager or IT Vendor

IT Managers/Vendors can determine if unnecessary programs are running on each device and optimize performance through a variety of debugging, defragmenting, etc. (Note: they will need a copy of the minimum specifications from your EMR vendor). This can help to speed up your EHR.

2. The Local Internet (LAN) is Slow

Bad cables, switches, routers, configurations, or too many devices can result in a slow EHR.

Responsible Party: This could be your internet service provider’s (ISP) responsibility, but they will likely need to be engaged with your practice’s IT Manager or Vendor for testing and configuration changes to discover the root cause of your slow EHR.

3. External Internet Connection is Slow

Usually due to a limited bandwidth (when hosted off-site). Slow internet or limited bandwidth can contribute to a lagging EHR.

Responsible Party: This is the responsibility of your ISP and it is a good idea to always procure the best connection that you can afford and ensure you are well above the minimum requirements/specifications for your EHR to increase EHR speed and reduce overall system slowness. Minimum requirements can be defined by each EHR vendor and the specific product/infrastructure you are using.

4. Not Enough Memory or Hard-disk Space on the Server

Responsible Party: IT Managers/Vendor can diagnostic tests and the EHR vendor can determine if resource availability meets their requirements.

5. Wireless Connectivity is Not Properly Configured

Responsible Party: IT Manager/Vendor can determine if firmware is out of date on related devices. ISP may need to be engaged if they supplied hardware.

Any of these issues can result in a latency, especially when data-heavy applications like electronic health records are being used. Most of these are simple fixes such as upgrading equipment, expanding storage, moving a wireless access point, and/or increasing bandwidth to improve the speed of your EHR.

However, if you have worked with your IT Vendor to correct the problems listed above and are still experiencing system latency and a slow EHR, you may have an issue with the EHR vendor and/or their hosting center. These are the EHR vendor’s responsibility to correct and their obligations to you regarding performance will be detailed in the Service Level Agreement (SLA) portion of your EMR contract. This should include EHR speed.

Here are some potential issues the vendor may be encountering that impact your EHR speed

1. Poorly Configured Infrastructure

Latency issues related “Software as a Service” (SaaS) or poorly configured add on modules (patient portal, e-prescribing, patient education, etc.) by the EHR vendor is not the responsibility of the medical practice to fix. Instead, it is the responsibility of the vendor to make the necessary improvements to increase your EHR speed. The downside is that while the vendor probably aware of the problem, the “fix” will be done on their time – (in most cases, not as quickly as the medical practice would like).

2. Overwhelmed Data Center

Even though the internet connections through most data centers are robust enough to handle EHR traffic, chances are they are handling information for more than one medical practice. Even large data centers can be occasionally overwhelmed and suffer temporary slowdowns. If your EMR is hosted and performs well outside of normal working hours, it may be an indication that the data center is being overwhelmed and resulting in a slow EHR during business hours.

Other reasons for EHR systems slowing down can include cyber-attacks. The most common cause, though, is that the EHR vendor is outgrowing its software due to rapid expansion of data tables or additional practice integrations.

3. Poor EHR Design or Code

How the EHR software is designed will affect EHR speed. Its speed should have been a primary consideration during the initial design. Once the software design is completed, it can be extremely difficult to make changes. Often, the software must be redesigned to improve EHR operating speed. This scenario can be further complicated by legacy integrations with practice management systems, or quickly configured modules designed to meet Meaningful Use Requirements.

Summary

Using electronic patient records is generally more convenient and faster than searching for paper files, and of course regulatory requirements continue to move the healthcare industry in this direction. Unfortunately, EHR usage can also slow down a medical practice’s overall system. Sometimes, it’s the responsibility of the medical practice to fix the issue, and other times it falls to the EHR vendor, IT Vendor or Internet Service Provider. Knowing who to contact when the system slows down is important. The last thing a medical practice wants or needs is to get involved in a “blame-game” with its EHR service provider. This won’t fix the problem, only add new ones.

Medical Advantage is deeply experienced in auditing and finding quick solutions to all the speed problems mentioned. We have extensive experience speeding up EHRs and adjusting networks for peak performance. We can also help facilitate meetings between your vendors to ensure they work together for your benefit. To learn more, contact us today.

 

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