Electronic Health Record (EHR) systems were implemented in practices throughout the country with the goal of developing and maintaining efficient clinical workflows, providing easier access to data, and improving communication between providers and patients. But years after President Barack Obama signed a law to advance the growth of EHR systems, many practices still struggle with points of confusion or frustration with their EHR system workflow.
It is necessary to diagnose and resolve these EHR system pain points in order to improve your clinical workflows. Follow these tips to identify your practice’s biggest workflow stumbling blocks.
1. Reach out to your staff
Communicate with your staff through email, in-person conversations, or a survey tool like SurveyMonkey, and record their responses. Ask direct and pointed questions to encourage specific answers that will help you pinpoint the problem.
Suggestions for questions:
- What tasks feel unproductive, but take up most of your time?
- Are there any areas of the system you feel you could use more efficiently that you would like to learn more about?
- During training, is there something that could have been covered better?
- Do you have the templates, order sets, and favorites lists you need?
Compile the answers to these questions and look for recurring themes. Target these common problems and make solving them a high-level priority, if they align with your organization mission and values. If the pain points lie in an area outside of your expertise, it may be time to contract with an outside consulting firm.
2. Look at existing documentation
Look at your organization’s EHR job aides, workflow manuals, and instructions. To ensure the standards you put in place are being carried out, review the procedures and instructions used to train new hires and observe to see if staff members adhere to the same guidelines, and if the guidelines are efficient.
When auditing the current documentation, consider:
- When was the last time this was updated?
- Do we feel confident that this is the most productive way to carry out this task within the EHR?
- Are directions easy to understand and are there pictures to help clarify?
- Can we simplify and still give the patients the best quality of care?
3. View your practice from the patient’s perspective
To get the full picture of your organization’s EHR workflows and where there are points of confusion or frustration, you need to view your operation not just on paper, but through the experience of a patient.
Shadow your providers, nurses, medical assistants, business office staff, and any other roles you have. Enter the clinic from the patient perspective and follow the course they take during a typical visit. Observe how your staff members use the EHR as they interact with patients.
Things to consider on your patient journey:
- Are there areas of their check in, rooming, visit, or check out that could be improved when it comes to their interaction with your staff and the EHR?
- Are you doing things to reduce check in times, like using a check in kiosk? Are patients able to fill out paperwork ahead of time on their patient portal?
Take time to observe management on your shadowing journey. Ask them about key workflows in their departments and areas that could be more efficient or effective. Listen to their beliefs, as many of those can be translated into projects that will have an impact on organizational function.
4. Examine the numbers
Finally, look at key performance indicators. In the financial metrics, pay attention to claims denials, bad debt, and accounts receivable aging. With clinical indicators, consider readmission rates and productivity measures. Look at trends and outliers by organization, department, provider, payer, and more to identify the biggest workflow issues and obstacles.
After identifying the pain points in your practice’s workflow, follow up by making the changes to optimize how the EHR is used in the practice. The likelihood of needing expert help grows exponentially in this phase. You may have the appropriate staff to tackle this on your own, or you may need to call in a trusted EHR Consultant such as Medical Advantage to assist with the optimization of your organization.