Can You Make Your EHR Less Annoying?

Paul Cerrato

Disclosures

November 20, 2018

In This Article

Will a Customized EHR Be More Helpful?

Other practices have taken a different approach, using their in-house IT staffs to help them build their own fully customized EHR. Family Health Centers of San Diego, a busy community health center with 24 primary care clinics, has gone that route.

Christopher K. Lee, MPH, its clinical solutions marketing manager, explained: "We tried several EHR systems, and none worked for us. Either the functionality was too limiting, or the vendors weren't responsive enough, or it simply cost too much. So we decided to build our own, which allowed us the flexibility to customize it as we want on our own schedule."

"Two things contributed to our success with the EHR. First, workflow changes: We created a clinical quality team who would review requests from our clinic staff and decide what enhancements our IT team should develop. They also engage with clinic staff in the rollout of new features. Second, flexibility and autonomy for clinicians—we structure our software in a way where clinicians can customize the pages, templates, flow sheets, order sets, smart phrases, and other functions to fit their particular specialty and practice style," Lee stated.

Of course, most practices are not in a position to drop insurance and don't have the resources to create an EHR from the ground up. Nonetheless, they can still reduce the EHR roadblocks that drain their time by first analyzing the way information flows through their practice.

Jay Strickland, CEO of the consulting firm Strategic Solutions of Virginia, recommends creating a visual diagram that outlines the way in which data are collected during the normal process of caring for patients. That can accomplish two things: It can uncover duplicated efforts, which are needless time sucks, and it can reveal "opportunities for streamlining processes for the benefit of both provider and patient." It also gives clinicians a template to share with their EHR vendor. If their product has some flexibility built into it, one can discuss ways to customize the EHR so that it is more closely aligned with the clinical workflow.

Although streamlining the workflow process and customizing an EHR may help carve out more time to interact with patients, your workflow is somewhat dependent on the way the exam room is laid out, which in turn can affect the doctor-patient relationship. If the room requires you to turn away from the patient to input data into a computer, that in itself may distance you from your patient.

Putting a laptop on a movable cart and positioning it between you and your patient allows more eye contact as you look over the top of the computer to talk to the patient. And if there are sections in the EHR that require patient input, you can turn the laptop around to share with the patient. Imagine, for instance, a diagram of the body that requires marking locations where a patient's pain is most severe. Sharing the diagram with the patient and asking, "Can you help me pinpoint your pain on this diagram?" can improve rapport.

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