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How to Treat the Plague of EHR Usability

“High volumes of data entry and poor usability associated with electronic health records (EHRs) are a main cause of physician burnout,” according to a recent AMA study of over 5,000 EHR users. Researchers found that, “Participants described their workloads as excessively heavy, increasingly involving less ‘doctor’ work and more ‘office’ work, and reflecting unreasonable expectations.”

More time on EHRs means less time on patient care

While it’s no surprise to medical practitioners, many physicians have experienced the demoralizing effects of cumbersome EHRs that hinder the delivery of first-rate medical care to patients. Worse yet, an ECRI Institute report states that, “…burnout impacts a multitude of medical providers, including not only physicians, but medical school students, nurses, allied healthcare providers, and organizational leaders.”

With the advent of such technological advancements as Amazon’s one-click ordering and simple Google searches, users expect the same sort of easy-peasy usability. Unfortunately, most EHR systems, as currently designed, implemented and regulated, don’t deliver when it comes to usability. They overload clinicians with type-and-click tasks instead of prioritizing time with patients. Face-to-face time with the patient has turned into face-to-screen to face time.

In fact, the ECRI Institute named physician burnout in their top 10 health technology hazards for 2020. “It’s very common for alarms, alerts, and other notifications to go off while a clinician is involved in patient care. These alerts typically come from medical devices, health IT systems, and EHR portals, taking attention away from patients. Responding to these notifications directly causes physician burnout and potential patient harm,” states an article in EHR Intelligence.

In an effort to help prevent or cure clinician burnout here are several tips to help make EHRs simpler to navigate and lessen the reporting burdens.

Launch voice-enabled technology

To improve clinicians’ lives, typing and point and click must go. The Harvard Business Review says that, “Voice and gesture-based interfaces must replace the clunky keyboard and mouse.” Here’s how:

  • Both documenting the clinical encounter and ordering should be done by voice command, confirmed by screen touch.
  • Orders should display both the major risks and cost of the tests or procedures ordered before the order can be confirmed. 
  • Interactive data visualization must replace the time-wasting click storm presently required to unearth patient data.
  • Results of voice searches of the patient’s record should be available for display in the nursing station and the physicians’ ready room.
  • The physician should also be able to prescribe by voice command everything from a new medication to a programmed reminder to be delivered to the patient’s smart phone at regular intervals.

Several companies, including Google and Microsoft, are already piloting “digital” scribes that convert the core conversation between doctor and patient into a digital clinical note.

Eric Schmidt, former Executive Chairman of Google parent company Alphabet, Inc., said, “Imagine a system that listens to the conversation, disambiguates the voices, follows the consultation, and gives suggestions to the clinician in his or her earpiece. It transcribes the situation so everyone has a record of the complete conversation, and then it fills out and navigates the EHR.”

Tap into artificial intelligence (AI)

Since the long before the beginning of the computing age, fiction writers and futurists have been predicting that self-aware machines will offer a cheap, tireless and error-free replacement for even the most complex of human skills. Today’s EHRs already have basic AI systems to help with billing, coding and regulatory compliance. But the primitive state of AI in EHRs is a major barrier to efficient care. Clinical record systems must become a lot smarter if clinical care is to predominate, in particular by reducing needless and duplicative documentation requirements. 

Of course, a new clinical workflow will be needed to curate patient-generated data and respond accordingly. AI algorithms must be used to delve into the EHR for information needed to assign acuity scores and suggest diagnoses that accurately reflect the patient’s current state. It is crucial that the EHR be able to prioritize alerts that address only immediate threats to the patient’s health in real time. 

“AI should do the things that it can do better than humans, but only in service of freeing up humans to use their good judgment for the things computers can’t do well,” said Dr. Joseph Kvedar.  “It’s about giving clinicians back their time to care.”

Use machine learning technology

The failure of current EHRs to achieve the goals of improving health care productivity, outcomes and clinician satisfaction is the result both of immature technology and the failure of its architects to fully respect the complexity of converting the massive health care system from one way of doing work to another. One can see a path to turning the EHR into a well-designed and useful partner to clinicians and patients in the care process.

Machine learning plays a major part in helping clinicians streamline their operations and slash the time they spend on EHR administration. EHR systems ca be tailored to pick out the most interesting information available, as well as the tasks they’re most likely to perform, and place them at the user’s fingertips. That will allow the clinician to spend more time with the patient.

Netflix can deliver a dozen movies that match the viewer’s taste in an instant. Physicians have to settle for a lot less than Netflix-type service with EHRs that basically tell users that, “If you don’t like it, tough!”  Instead, users should be able to make simple changes to the way their EHR interfaces appear to simplify their interactions.

Enable team-based care

Team-based care, or the partnership between physicians, nurses, advance practice practitioners and medical assistants, has been hyped as a key strategy for eliminating clinician burnout. With this strategy, medical assistants and other medical professionals can ease some of the burden off physicians and nurses.

One possible solution is for the EHR to prompt medical assistants, rather than physicians, to set up and order screenings for physicians to sign once they see the patient. Due to doctors’ busy schedules and clinician burden, the scheduling of preventative screenings, such as cancer screenings, sometimes slips through the cracks. Physicians also reported the need for a better way to distribute tasks to the appropriate members of the clinical team, helping to improve communication between care team members.

Turn to outside consultants as needed to train your medical staff

These consultants can readily help physicians and other medical staff master the ins-and-outs of EHR and use the system more efficiently and effectively. Plus, outside consulting experts can help with your organization’s unique clinical workflow and configure the system, as needed, to make it more user friendly.

You should make sure that the consultants you bring on board have real-word operational experience and:

  • Are well-versed and experienced in the healthcare environment
  • Can match training solutions to the specific needs of physician usage and satisfaction
  • Understand the implications of regulatory changes in health care
  • Have deep EHR knowledge and related technologies
  • Will deliver actionable and positive outcomes doctors will want to use day-in and day-out
  • Augment training with areas such as utilization management and assist with Prior Authorizations, Concurrent Reviews, Grievance and Appeals, Audit, Auth. Chex, HEDIS, Data Entry (clinical and not clinical personnel), and more!

Talk to Blue Eagle’s experts

Blue Eagle Consulting EHR training/consulting experts can analyze your IT environment, understand your pain points and objectives, and help your organization discover solutions that meet the challenges of physician dissatisfaction and burnout. If you have a project coming up or a need that we can fill, please call us at 1 (866) 981-1095 or email info@blueeagle-consulting.com.

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