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Working With IT Staff to Improve EHR Usability

Series: Electronic Health Records

IT departments can help improve EHR usability and reduce physician burnout through better health IT design. EHR developers and designers are expected to provide a better EHR in the future, but while the next generation EHR is in development, the IT staff at your practice (or your vendor or a consultant, if you do not have IT staff) may be able to improve the usability of your existing system.

Multiple small changes to EHR usability can have a significant effect on the administrative burden caused by an EHR. Consider requesting the following EHR customization strategies:

Limiting EHR Alerts

Limiting clinical decision support alerts can reduce burnout. Clinical decision support (CDS) at the point of care was initially touted as a patient safety strategy, but alert fatigue and information overload significantly diminishes the benefits of CDS and can contribute to physician burnout. There are various EHR solutions for reducing alert fatigue in healthcare.

Impact of a National QI Programme on Reducing Electronic Health Record Notifications to Clinicians
This article discusses the impact of a US Department of Veterans Affairs multi-component, quality improvement (QI) program to reduce low-value EHR notifications.

How One Hospital Tweaks Its EHR to Fight Alert Fatigue
This article describes how the University of Vermont Medical Center customized its EHR systems to reduce alert fatigue.

Managing Your In-Basket

Many items in clinician EHR in-baskets can be managed by other members of the patient healthcare team. While staff should never be asked to engage in the unlicensed practice of medicine, in-basket items can be divided up in a way that allows all team members to better practice at the top of their respective licensures.

EHR In-Basket Restructuring for Improved Efficiency
The American Medical Association has created this CME course to help physicians learn how to keep unnecessary messages from being routed to their in-baskets and to establish a centralized team in-basket.

Improving the Password Process

Physicians and staff devote a measurable portion of their day typing passwords into workstations. Single sign-on technology (SSO) allows users to sign-on at the beginning of their shift and then streamlines subsequent sign-ons until sign-off at the end of the shift. SSO not only can eliminate password confusion and wasted time, but also can enhance HIPAA compliance.

Clinical Impact and Value of Workstation Single Sign-on
This article highlights CHRISTUS Health’s implementation of computer workstation SSO technology, which utilizes an identification badge reader at each workstation.

Customizing the EHR Interface

The out-of-the-box desktop view delivered by the EHR vendor may not be organized in the best way for a particular individual or specialty. Aspects of the EHR desktop generally can be customized in some manner to create a simpler, more intuitive interface. Clinicians without IT departments may be able to take a refresher course from their EHR vendor to improve the look and feel of the EHR.

Physicians Ease Growing Pains of Electronic Healthcare Records with Mobile Technology
This article discusses ways in which additional technology options may be added to the EHR to achieve more customization.

Finding the Best EHR Data Input Method

There are various ways to enter data into an EHR: voice recognition, dictation, scribes or remote scribes, templates or some combination of different methods. Every physician works differently, and it’s important to find the data entry method that works best for you.

Speech Recognition in Healthcare: a Significant Improvement or Severe Headache?
Speech recognition (voice recognition) technology can convert spoken words into EHR usable data. This article describes the ways speech recognition technology works and the feasibility of using it in clinical practice.

Medical Transcription Services: How to Choose and Negotiate
This article describes different aspects of using transcription services and compares transcription to voice recognition.

Requesting a Shadow

Ask an IT person familiar with your EHR system, a vendor representative, or a consultant to observe the way you use the EHR in-clinic and, based on their observations, provide individualized coaching and training.

Shadowing Reveals More Efficient Ways to Practice Medicine
This article discusses how shadowing can identify inefficiencies in the way a particular clinician uses the EHR, which can facilitate changes in workflow and data-entry delegation.