How To Sustain High Productivity After Implementing An EHR

By Alok Prasad, president, RevenueXL Inc.

Talk with any physician, and they’ll likely voice concerns about the EHR, including its cost and potential drain on productivity. Physicians fear that even after a costly and time-consuming implementation, the EHR will create an additional burden and require more of their time, allowing for fewer minutes of face-to-face interactions with patients.

Although physicians generally appreciate the efficiencies created by EHR e-prescribing and electronic lab results, they also feel frustrated by the technology in general, according to a new poll conducted by Medical Practice Insider in conjunction with physician community QuantiaMD. The poll found more than 60 percent of physicians do not consider their EHR a worthwhile investment.

On the other hand, many studies indicate just the opposite – physicians are becoming more accepting of EHRs and the technology has many benefits when implemented correctly. According to a survey conducted by Medical Economics, 55 percent of physicians are fairly or very satisfied with their EHRs, and 54 percent believe they have helped improve the quality of care. Forty-five percent of respondents said that EHRs have had a positive financial impact on their practices. Various providers have gone on the record regarding EHR benefits, stating they’ve experienced a specific return on investment after having implemented the technology.

To effectively assess productivity before and after implementation of an EHR, practices must identify and understand the factors that can potentially have a detrimental effect on efficiency. Simply installing an EHR doesn’t mean that practices will experience increases in efficiency automatically. Instead, practices must work to integrate the technology into their workflow. This article outlines seven EHR implementation mistakes that can result in productivity decreases.

1. Not obtaining proper buy-in from physicians and other staff members. When it comes to EHR implementation, everyone in the practice must be on the same page. One anti-EHR individual can potentially sabotage the practice’s entire efforts. A physician or practice manager must explain why the EHR is essential for patient care and that it’s not meant to replace any particular functions or jobs.

2. Not performing a workflow analysis. Mapping the practice’s workflow is a critical part of EHR success. A workflow analysis should include an in-depth look at the ways in which documents, information, and people affect a specific process with the goal of improving the efficiency of that process. Such an analysis can often accomplish the following goals:

• Determine the most efficient location for EHR terminals within the practice.
• Reduce long-standing bottlenecks related to patient processing and care.
• Provide staff and physicians with better access to information and documentation tools at their fingertips – where and when they need it most.
• Identify other opportunities for improvements in efficiency that the EHR can support.

A workflow analysis webinar provided by the U.S. Department of Health and Human Services suggests that practices should consider these questions:

• How do we do perform this process or function currently?
• What EMR functionality do we need to improve efficiency?
• How will we use the EMR to perform these steps?

3. Not customizing EHR templates. Customized templates not only improve efficiency, but they also promote personalization and organization. Providers can work with their EHR vendor to identify specialty-specific templates as well as strategies to customize those templates depending on a patient’s unique scenario. The goal is to capture as much information as quickly as possible and with as much detail as possible.

4. Not taking the time to train employees sufficiently. Improper or insufficient training can quickly cause dramatic decreases in staff and provider productivity. Consider these tips:

• Provide training as close to go-live as possible.
• Require the vendor to provide training onsite as opposed to via a remote platform (e.g., webinar, online training course, or online video).
• Work with the vendor to provide a training session that is tailored to your practice.
• Provide basic computer training for those who need it prior to formal EHR training.
• Provide sufficient time for training and questions – Don’t rush through the training in an hour and then hope that staff members can figure the rest out on their own.

5. Not checking your practice’s infrastructure. A practice’s infrastructure — the hardware and bandwidth used to connect the computers in a network—must be robust enough to support an EHR. Not having enough bandwidth can cause unnecessary downtime or delays in access to labs, e-prescribing, or drug safety checks that lead to productivity disruption. Consider these questions:

• What are the vendor’s minimum bandwidth specifications?
• How many computer terminals will include access to the EHR?
• What other major programs does the practice run?

6. Not delegating tasks to certain staff members. A study published in the American Journal of Managed Care found that clinicians are more productive when they find ways to delegate tasks to support staff. Practices can gain efficiencies when each staff member understands his or her explicit role related to the EHR.

7. Making assumptions about what the EHR can—and can’t—do. A study published by the Electronic Data Methods (EDM) Forum found that although EHRs have the potential to facilitate improved efficiency and documentation, practices still need policies, procedures, and workflow redesigns to reap the rewards.

Think efficiency, not productivity drains
EHRs don’t necessarily need to be a drain on productivity. In fact, just the opposite can occur when practices take the time to identify the barriers to productivity and address them head-on before, during and after EHR implementation.

About The Author
Alok Prasad is the President of RevenueXL Inc. which is a leading provider of healthcare solutions, providing Certified PrognoCIS EMR Software to small and mid-sized practices. RevenueXL offers 30-day free EMR trial as well as free EMR in conjunction with its medical billing services.