These days, we’re deluged with statistics on medical practices determined to show their EMR the door — but I’d like to believe that it’s possible for doctors and EMRs to have a happy marriage.
A few months ago, on question-and-answer site called Quora.com, a health IT expert named Mark Olschesky posted a nice list of factors which he believes are critical to a successful EMR/practice relationship. I thought they were worth sharing:
* Doctors, clinic staff and administrators agree on business metrics and functions they want to improve with the EMR.
Some examples proposed by Olschesky:
· Right now I need to do manual chart reviews for research and I have to hire 3 staff to help me with this. I’d like to build forms so that I can do this automatically.
· It takes us 7 days to send follow-up communication to referring doctors. Can we speed this up to one day?
· I’d like to prove that I do a comprehensive visit so I can bill the proper amount of money for a visit.
· We would like to know every child that has a difficult airway and fire a warning every time we access their chart in the hospital so that everyone knows they need to prepare for a tricky intubation. This can save lives.
· I do the same thing 50 times a day and I don’t want to do that anymore. Can you standardize the way that I do x thing 50 times a day?
* The tech contact person needs to meet with clinicians regularly and get their feedback on what they want.
Rather than simply coding up new features or tools, the IT person needs to have clinicians check out the tools they are building before they go live with them in the system, he says. Some practices are loathe to take the time it takes to slowly and carefully build out, but they should grit their teeth and do it anyway. “It pays out at a major multiplier,” Olschesky notes.
* Practice leaders need to be absolutely clear about which organization-wide decisions are being made and how that plays out in how the system will be configured.
Rather than simply unveiling the system at go-live time, there should be an easy channel for clinicians to submit feedback and share what changes they think will be helpful to them, Olschesky says. Otherwise, groups may end up with doctors who are needlessly unhappy. While some unpleasant or unpopular features may still be necessary, due, say to regulatory requirements, none of these features should come as a surprise to users.
* Practices should make sure that *plenty* of training opportunities are offered.
Everyone in the practice should get enough training, specialized to their function, and everyone should be able to practice before the software is turned on. And everyone in the practice should give the system a test run with simulated patients before go-live, he advises. Why? Well, aside from the obvious need to be oriented, there’s no such thing as a no-brainer EMR, he says. “This might make some UI/UX people cringe, but I’m going to say it: We can’t design an EMR solution that is totally obvious and requires no training and no practice,” he argues.
Getting the core EMR workflow to a level that’s comfortable to physicians is obviously of tremendous importance. But it’s not just a matter of getting physicians to a point where they can function. Practices will never be able to leverage the EMR to take care to the next level if they’re struggling to cope with the basics — and that’d be a real shame.