How to Solve Your Medical Practice's Toughest Challenges

Kathy I. Moghadas, RN, CLRM, CHBC


October 11, 2017

In This Article

Another Reason to Fall Behind: The EHR

What causes a major bottleneck? Almost one half (49%) of physicians allocate time between patients to document patient notes. Electronic health records (EHRs) have been created to allow the physician to document in real time while visiting with the patient. But a large percentage of physicians cannot effectively integrate the EHR documentation process in real time during the patient visit.

There is a potential avenue of help in this situation. With only slightly over one fourth (26%) of the respondents using voice recognition software, I recommend that physicians who are consistently struggling to document during the visit consider using practice scribes. The use of scribes is not for everyone, but it could be helpful for physicians who aren't efficient with their EHR.

After maximizing your office technology and designing the perfect scheduling template, it's wise to look at some of the ways to improve and to be more efficient.

The survey respondents who embraced the EHR said it assisted them with e-prescribing, reduced cost of dictation, speeded updating of patient information, increased ease of typing, facilitated sharing of clinical findings across providers, and made access to diagnostic and test results and charting of patients' clinical course of treatments easier.

In our experience, patients have become much less frustrated with physicians' use of the EHR. Just as many years ago, people were angry about the use of automated telephone responses but these are now accepted as a fact of life, the same is happening with EHRs.

Physicians reported that their patients who used the patient portal tended to be adept at using an electronic patient portal and also appreciated their record being kept electronically. It appears that patients as well as physician respondents were more satisfied with having patients access their records through the secure practice online portal to reduce administrative tasks ranging from follow-up on lab and diagnostic test results to email communications with healthcare providers, requesting prescription refills and scheduling appointments, and completing forms and paperwork. Ensuring that patients who have additional paperwork to complete are called and reminded to do so can reduce that bottleneck.

The use of secure practice portals is taking hold in medical practices, but it's still a minority of patients who use the portal. It's predicted that the number will grow over the next 5 years, however, and that clinicians will use the telephone less and use the patient portal more as the prime means of patient/practitioner communication. This is true for physicians of all ages; I am happy to report that even among the proportion of respondents who were older than 45 years, many were pleased with their technology and EHRs.

This finding reminds me of my 60+-year-old family medicine physician client, who 10 years ago was very resistant to getting an EHR when we encouraged him to do so. That doctor confesses that his practice life is much less bogged down with minutiae these days, thanks to the EHR. He has even developed the skill of making eye contact during his patient visits rather than staring at the computer screen.

Other sources of bottlenecks are delays in patients completing their paperwork, patients showing up late for appointments, and not allowing enough time for the patients to be seen. These are all patient management issues that should be dealt with by your administrative staff. Staff should be encouraged and trained to do patient rescheduling, work with the patient to complete paperwork, and find other means to accommodate the patient management process. Making sure that the patient has completed the paperwork before the visit is a big help with this issue.


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