Electronic Health Records (EHRs) have a bad reputation. With emerging complaints about the many hours spent on EHRs from healthcare providers, one may question whether electronic health records might not be the solution that was promised to guarantee higher productivity and better patient care. If EHRs don’t save care providers time and improve profitability, you must wonder why anyone would want to switch to an EHR system from paper records?
EHRs, like all software and systems, are not necessarily to blame. When leveraged correctly, they can change practices for the better. EHR productivity gain or loss is specifically linked to how well the practice takes the time to determine what they want out of their software and strategize implementation. Customization of the product further optimizes productivity and without it, costs specialists’ effectiveness or time. With those two things in mind, doctors should know that going digital really can help save them time and deliver better health outcomes.
The loss of productivity often can come even before a practice implements an EHR. When office managers, the spouse of the doctor, or the medical staff in a practice is given the responsibility to, “Find us an EHR and let me know when I can start using it,” the practice is already in trouble. They shop around, compare prices and product features with the current processes the practice uses, and select an option for the practice. Sometimes, the doctor(s) come in at the last minute to approve or sign. This guarantees a practice will lose productivity and profit before using the EHR software. Without well thought through priorities, a practice won’t be able to either select the right EHR or implement it properly to meet its specific needs or both.
Before starting to attend product demos, providers and their team should sit together to figure out what they want out of the EHR system and make a list. Do they want to leverage the ability to automatically remind patients of their appointments without having to have the receptionist make multiple phone calls? Do doctors want their chart notes to be written quickly and concisely with templates based on their key clinical findings during patient visits? A guide based on what’s prioritized in the discovery should be used when shopping for a product.
Selecting a product solely based on the way the practice currently is run is like buying an iPad with dial-up internet; the two aren’t very compatible, if at all. Providers and practice staff should pay close attention to how each vendor suggests and shows the use of their product. Seeing demonstrations from different EHR software companies will indicate how the vendor’s product can accommodate the practice’s needs. Resolving differences between how the EHR software is designed and how their practice will run determines whether the product is compatible and if it will improve or decrease practice productivity. Next a practice should look at specific EHR functionality.
First, being able to build templates specific to a provider’s intake and specialty should be a basic function everyone looks for in their electronic health records software. A key reason for moving to an EHR software is to save provider’s time. The more EHR software can be customized to provider’s specific needs, the higher the provider productivity will be. Having macro building tools as a part of medical templates is another time saver. The macros when built correctly can reduce charting time to seconds or merely a few minutes. An EHR is as good as how it’s customized to fit the practice needs, so investing time and effort to learn and utilize the available tools in the beginning will go a long way to minimizing time spent on documentation.
One question that not many providers ask is how modern and integrated the underlying software is. This is a very important question to ask for two reasons. One, systems built on old legacy software programs don’t talk to each other that well. When this happens, EHR software will not pass the patient health records automatically to other parts of the system such as medical billing, lab ordering, etc. Then staff or providers will have to enter data multiple times which will incur more time and prone to data entry errors. Watch out for the EHR companies with separate medical billing and other systems as they will likely require you to do multiple data entry and that will not improve productivity. Two, an EHR system built on old software program will likely not be able to integrate with other apps or programs well and quickly. This will be problematic when a practice needs to integrate with a third party scheduling app or other services that will help you certify for meaningful use, or provide telehealth or digital health program. And the list goes on.
With a full schedule of patients and more calling to be fit in, practitioners and their staff need to be spending less time on the phone ordering labs, medications, scheduling appointments and spend that time taking care of their patients. The more that can be safely automated gives the practice more time for patient care. For example, with controlled substance prescriptions being digitally authenticated, pharmacy networks are becoming more experienced with digital orders which can save time for patients, practices and pharmacies. It’s important to find an EHR software that can leverage a large network of pharmacies to electronically prescribe and refill both regular and controlled substance medications.
Being able to electronically order labs and imaging and receive them directly into patient chart can improve patient experience as well as save a huge amount of time and money spent on fax machines, direct mailing or travel between labs and practice. This makes finding an EHR compatible and connected with a large network of labs and imaging centers very important. Digital is truly the answer in getting quality clinical information faster, but interoperability is what that rests on. So, look for an EHR company that has capability and business process to easily integrate with external partners.
Patient scheduling and engagement is another time consuming part of practice management. Many times, the patient portal is an afterthought of EHR selection process but it is a key time saving component for practice staff. Providers and staff should ask how much patient engagement work can be automated and be done online. Enabling patients to use patient portal to make their appointments online and being able to send automated reminders via phone call, email or text message keeps staff attentive to the needs of patients currently in the office and other critical practice duties.
HIPAA compliant online messaging and being able to share digital form of patient education materials are also critical to improve productivity. An effective EHR should enable providers and staff to improve their productivity by not having to spend too much time on phone calls or managing paper copies of patient education material. By allowing patients to access their health records and communicate from home, you are also giving them more opportunities to learn and manage their own health situation. Even if patients have questions after reviewing the material, they can easily send a message securely to their providers.
The right EHRs can and do help practices save time and can improve profitability when utilized correctly. For private practices, being able to automate menial tasks and see more patients will directly influence their survival. In addition, automated tasks and improved patient experience can lead to better patient healthcare. To choose the right EHR, the practice has to ask the right questions. The worse situation for any practice will be having to switch to another EHR later because the first one was a poor fit. Do you have the right EHR that fits your practice and are using it correctly?