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6 Ways EHR Might Be Holding You Back

Electronic health records (EHR) are here to stay. There’s even a federal program administered by the Centers for Medicare and Medicaid Services (CMS) to encourage “meaningful use” of digital documentation. On the surface, the idea of implementing EHR is great: issues with illegible handwriting and sharing paper records should be eliminated, and information and data captured can be used to benchmark performance and improve patient care.

However, the reality of everyday EHR use is much less straightforward. According to a recent, comprehensive report on how physicians feel about their digital documentation reveals a number of problem areas. Here’s a look at 6 areas where EHR might be holding you back, and what you can do to address these issues and smooth the path to achieving meaningful use and securing full incentives.

1. Data entry is time-consuming. The majority of physicians who use their EHRs directly, without using a scribe or other assistant, reported that data entry was cumbersome and took up too much of their time that could otherwise be used for patient care.

2. User interfaces are not in step with clinical workflows. EHR prompts — or failures to prompt — through clinical workflow in a user-intuitive way are seen as hampering information collection and diagnosis during patient appointments.

3. Face-to-face care is hindered. When physicians are interacting with the EHR as they go, they say interaction with the patient suffers. Although physicians in the report blame themselves for not being able to pull off this delicate balancing act, the choice is plainly a difficult one: divide attention while the patient is in the room, or wait until later to perform the actual data entry. The latter situation lengthens work hours, not to mention risks inaccuracies because the information is not entered in real time. Scribes solve both issues, letting physicians maximize the quality of interaction with patients and minimize time spent on administrative tasks.

4. Meaningful-use criteria don’t match clinical practice. Both primary care and specialist physicians reported that meaningful-use criteria aren’t necessarily aligned with the most important elements of patient care (such as interaction and a quality experience), meaning that the EHR tail is sometimes wagging the clinical dog.

5. Physicians end up doing lower-skilled work. Physicians who did not use scribes or other assistants reported that their EHRs required them to perform tasks below their level of training, decreasing their efficiency. That is, they are trained for medical care, and should spend their time focusing on it. Scribes — who have the knowledge and skills to record patient information in real-time — ameliorate that issue, freeing physicians to do the work they’re meant to.

6. Template-based notes can degrade documentation quality. Although templates standardize the process of writing clinical notes, many physicians reported that they were over-complicated, impeded retrieval of useful clinical information and blocked the flow of data entry.

What’s more, physicians reported that these issues don’t go away with time, nor does upgrading to more complicated systems improve satisfaction with use. Although the report acknowledges that physicians are enjoying better access to patient data, improved tracking of guideline compliance and disease markers, and better communication with patients and between providers, it’s drawbacks such as the ones above that are holding back the full potential of EHR — and why the AMA is calling for reform. As noted by physicians in several points of the report, the use of scribes can free up physician time for patient care, improve interactions between physicians and patients, and result in better-quality clinical documentation.

Michael Murphy, MD
Dr. Michael Murphy is co-founder and Chief Executive Officer of ScribeAmerica, LLC. He co-founded ScribeAmerica in 2004, and it is now the country’s largest and most successful medical scribe company with a staff exceeding 7200 employees operating in over 46 states nationwide. Today, ScribeAmerica is the recognized leader of the medical scribe industry and remains at the forefront of professional scribe education, training, and program management nationally. Dr. Murphy served as an Army Ranger for the 1st Ranger Battalion in Savannah, Georgia, which allowed him to gain various leadership skills along with the ability to develop standard operating procedures. He applies this to his daily duties for ScribeAmerica. Dr. Murphy has been a leader on multiple issues including scribe policy, hospital throughput, electronic medical record implementation and optimization of provider to patient ratios. His goals are to continue making all medical practice locations an environment built for an exceptional patient experience that allows providers to focus solely on patient care. Dr. Murphy received his Doctor of Medicine from St. George's University and completed his residency training in Emergency Medicine at the University of Medicine and Dentistry of New Jersey in Newark. He has co-authored one textbook and is involved in 3 peer review articles.
Posted In: Best Of, General, Quality, Efficiency, Utilization On: Wednesday, 8 April, 2015

2 Comments

  • Elvira - October 26, 2015

    I’m sure, just like the auto dealers with their $4500 cash for clneruks program, EMR upgrade stimulus will get tied up for months and months with paperwork errors, processing errors and the like. Just like when dealing with Medicare and Medicade. I’d rather keep my own tax money and just document with my Rapid EMR system just because it makes me faster and more efficient saving me time and money. Which, in the end, gives me my own stimulus

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