Optimizing Office EHRs Principle 10: Invest for EHR Success

Principle 10 of a 12-part series on Optimizing Office EHRs

First Measure the Cost

Including the cost of doing nothing...

Why invest for EHR success?  I learned two economic principles early in life:  "You get what you pay for," and "There is no free lunch!"  But my favorite saying is, "Man who stands on mountainside, with mouth open, waiting for roast duck to fly in, has long wait." I have observed thousands of doctors using their EHR, and most could use them better.

But change is an inside job.  For a physician/user to invest for EHR success, one needs a belief that improvement is possible.  I have penned this series believing everyone can further optimize the office EHR. If you are already at peak EHR performance, you may skip this part.

Invest for EHR success to balance Time, Money and Peace of mind shown graphically.
Invest for EHR success for more time, money and peace of mind.

Principle #10: Invest for EHR Success

Throughout this series I have been taking you through optimization steps for your office EHR.  Most of these require your self-assessment, a plan, and execution.  The following five investments should improve your daily productivity.  You may have done some of these already.  However, I have found through the years that most EHR users, regardless of their current proficiency, will benefit from these five steps.

Invest for EHR success by learning new features...

Many teams who manage EHRs will take code upgrades and implement them using a "like-for-like" technique.  This means that they will often leave new enhancements turned off during a version update.  They do this to minimize the need for training and to minimize disruption of their current users.

Though the intent is to come back later and implement the enhancement, the latter may never happen.  Other priorities may get in the way.  It is worth the user's time to find out what enhancements are already in your EHR that you have not yet taken advantage.  It may provide you some new efficiency or convenience. You will not know if you don't take the time to ask.

Invest for EHR success by coaching the staff..

It is not uncommon to find that the staff is unaware of how their EHR use impacts the physician.  Perhaps they are missing an opportunity for entering patient information to help the physician see or include it into the office note. Maybe they have tools that they don't know how to use.  Maybe they are doing 20 clicks when four clicks would suffice.

Regardless, it is important that the staff be comfortable and efficient with the EHR.  As staff spend less non-value-added time with the EHR, they can use that additional bandwidth to improve office throughput, efficiency and patient satisfaction. Typically the physician knows shortcuts that the staff doesn't yet know.  Discuss this at your next office meeting.  Start sharing ideas to improve everyone's EHR knowledge and use.

Invest for EHR success by optimizing access tools...

Years ago monitors and computers were very expensive. Not so much today. So look at the hardware you are using in the office.  Would a larger monitor help?  Would a dual monitor set-up help?  Do you have enough devices for peak times?  Would a tablet or notebook/laptop computer make you more productive?

Devices are no longer a major barrier to EHR use.  So make sure you have the right type and amount of equipment to get the job done.

Invest for EHR success by updating your EHR version...

This is often confused with the first point above and represents another missed opportunity for many office-based physicians.  Every time your EHR vendor offers an update, review the list of enhancements that become available with it.  If there is a new enhancement that will make you and/or your staff more productive, you want to know what it will take to get it available for use.  If they include this in your next upgrade, implement a training plan for you and your staff.  If a "like-for-like" upgrade will not include the benefit, make sure there is a second phase of the upgrade to give you the new feature as soon as possible.

Vendors create enhancements based on the feedback from hundreds of users.  Make sure you know what the new ones are, and decide whether they will be beneficial to you.

Invest for EHR success by learning new tips and tricks...

Even though I first started using EMRs in 1993, I still learn new techniques on a regular basis.  EHRs are like any other area of medicine.  Consider the growing number of tests, imaging studies, and medications that we have to learn each year. The EHR is no different.

Maybe it is a better way to perform medication reconciliation.  Maybe  a new documentation template.  Perhaps there are new codes to learn for billing.  Perhaps some new CDS rules are in place.

There are a lot of places one can find tips and tricks.  Perhaps you have someone in your office that is at peak efficiency.  Many EHR vendors provide video libraries and tip sheets.  There are user groups, webinars and conferences.  Reach out to your EHR vendor and your "EHR fixers" and discover what they have available.  Your goal should be to learn one new productivity tip every week.  Over a year this can produce considerable time savings.

All these efforts may take some investment in time and money to help you optimize your EHR.  But with effort and commitment, you can see a noticeable difference in your productivity and make next year even better.

Action Plan for Principle #10: Invest for EHR Success

Consider the following questions and actions:

  1. When was the last time you learned new EHR features?
    • Discover what new features are currently available and how can they help you.
  2. Is your staff at peak performance with the EHR?
    • Consider sharing tips and tricks that will benefit everyone.
  3. Are the devices in the office optimal for your productivity?
    • Consider where mobile devices or dual screens might improve efficiency.
  4. Are you running the latest version of your EHR?
    • Check with your EHR vendor to see if you have the latest version and the potential benefits of an upgrade.
  5. How are you learning new tips and tricks?
    • Discover the process for getting new ideas on EHR use from your vendor, user groups, and/or your support person.

Catch the Introduction for this series:


More on the 12 Principles for Optimizing the Office EHR (Published weekly):

  1. Know what you want. See "First, do no (EHR) harm"
  2. Commit to moving forward. See "Don’t look back"
  3. See your EHR as a practice improvement activity.  See "Where do we begin?" 
  4. Use Your EMR as an EHR. See "Is Your EMR an EHR?
  5. Eliminate Waste. See "A penny saved, is better than a poke in the eye"
  6. Make the EHR Work for You. See  "Know thyself".
  7. Reduce Cognitive Load.  See “Saved time will keep us together".
  8. Patient Focused. See "Whenever I call you friend”.
  9. Rediscover Your EHR. See "Read between the lines".
  10. Invest for EHR Success. See "First measure the cost" on this page.
  11. Eating the elephant one bite at a time
  12. Nothing’s “gonna” stop us now.



The 10 Myths of Office EHR

Myth #1:  I don't own my EHR, so I cannot fix it.

Myth #2: We have the wrong EHR for my practice.

Myth #3:  There is no way the EHR can save me time.

Myth #4:  I just need to go back to paper charts.

Myth #5:  EHR office notes are never going to be usable.

Myth #6:  The EHR cannot make my patients safer.

Myth #7: I don't have the time to fix my EHR.

Myth #8:  It's not up to me to fix my EHR.

Myth #9:  To use my EHR, I have to see less patients.

Myth #10: You don't understand, my practice is different.

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