Optimizing Office EHRs

12 Principles for Optimizing the Office EHR

Many physicians complain about their electronic health records (EHRs) in their offices and clinics.   They commonly vocalize their complexity of use, a loss of productivity, and reduction in the quality of their medical records.  Dr. Phil Smith introduces 12 principles for optimizing office EHRs.  He started using electronic medical records in his own family practice office in 1993. He has since automated over 60 hospitals and countless physicians and their office workflow.

Dr Smith frequently visits facilities that have not had great experiences with their EHR or are not realizing the benefits that they could.  These principles will focus on the physician office.  He has previously discussed hospital EHR optimization in his book,  Making Computerized Provider Order Entry Work (Springer, London, 2012)

Dr. Smith lays out 12 principles that physicians can utilize to optimize their EHR workflows  His goal is to empower physicians, staff and practice managers to view their EHR as an asset and learn how to best leverage it for success.  He offers practical examples.  He has included memorable titles for each section and stories to support an action plan.

The Twelve Principles for Optimizing the Office EHR:

  1. Know what you want: time, money and/or peace of mind.
  2. Accept that we are not going back to paper charts and dictation
  3. Start from where you are
  4. Use your EMR as an EHR.
  5. Leverage your EHR to maximize revenue
  6. Acknowledge that happiness is an inside job
  7. Know the tricks for peak personal efficiency
  8. Tell the story of the patient
  9. Optimize your schedule and stay on time
  10. Set and achieve measurable goals
  11. Don’t try to fix everything at once
  12. Be an EHR winner and not a victim

Dr. Smith hopes that this series offers practical advice on how physicians and their practice managers can discover value in their EHR for the benefit of their practice, staff and patients. He is also directing this to informatics colleagues who gain to understand how best to help physicians and mid-level providers to benefit from their EMR investments.

We recommend you start with Principle 1:  First, do no (EHR) harm which discusses the first principle: "Know what you want."  This 12-part series is being released weekly.

More on the 12 Principles for Optimizing the Office EHR:

  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".
  11. Work Your Plan. See "Eating the elephant one bite at a time".
  12. Realize EHR Benefits. See "Nothing’s “gonna” stop us now".


For information on Optimizing the Hospital EHR, see Getting Value from Your EHR.