One of the best ways to improve EHR satisfaction is through the use of personalization tools. Ironically, most organizations tend to use this tactic sparingly. Personalization is the tweaking of the EHR to better match it to the practice style and workflows of an individual or group of providers. EHR personalization should start at the time of initial training. Most organizations that prioritize personalization follow up with providers at thirty, sixty and ninety days because providers learn what their style of practice looks like in a new EHR gradually. Ongoing personalization can then occur as part of a provider’s four hours of recommended annual training or through advertised “drop-in” labs or kiosks. Personalization should evolve as the EHR evolves.
I like to break EHR personalization tools into five basic categories: documentation tools, ordering tools, reports, filters, and workflow optimization tools.
Documentation templates are one of the best ways to speed up a provider’s work in the EHR. Templates are typically designed around a disease or symptom in their most basic form. Templates should be designed to pull information already present in the EHR, like clinically relevant labs and vitals, medications, and physical findings. Picklists, smart phrases, and drop-downs can also be configured to capture data and findings typical to the disease or symptom. Macros can then be created to auto-fill a given provider’s “typical normal exam.” From there, the provider then just needs to document any changes from the normal present in the given patient. One caveat: Take care not to pull too much data into the note. Instead, pull in only what is necessary to get the point across clinically; the adage of “if it’s not in the note, it can’t be billed,” is just not true. If providers acknowledge data relevant for billing in the record, it does not need to be pulled into every note! Provider’s notes should be clinical communication tools, not billing tools.
Ordering tools, such as sets and picklists, also significantly speed up the process for finding and placing of orders.
- Orders sets, like documentation templates, are typically based on a given disease or presenting complaint, and group orders commonly used for that condition. Order sets can be based on a first presentation of a disease or complaint or based on the ongoing care of a disease. Like documentation templates, providers can expand upon this customization by saving their preferences within an order set, further speeding up the ordering process.
- Picklists are lists of orders a given provider regularly uses for rounds, clinic visits, consults, and the like. They make the finding of these frequently used orders faster and easier. Additionally, as an individual’s practice patterns evolve, they can choose edited these picklists over time.
Reports are designed to pull data from disparate EHR sources into a consumable format in order to aid decision-making. The uses are endless, but typical reports can be based on a patient population (disease, location, treatment team, etc.), a given patient (all relevant info on their diabetes, for instance), or any other data set that can help with the providing of care.
Filters can typically be applied in many areas of the EHR and can help focus the endless data to consumable and appropriate data sets. Most EHRs allow the saving and sharing of particularly useful filters.
Workflow Optimization Tools
As much as possible, plan to lay out the EHR to match the workflow of a given provider, clinic or specialty. Ordering tasks in the EHR in the sequence in which they are typically performed markedly improves the speed at which a provider can move through their day. Whether it is the order tasks are performed in a given clinic visit, on rounds or during a consult, or whatever the workflow is, if they follow the pattern of the provider, they will be easier to complete. Another advantage of workflow design is that they can remind providers to do things that might otherwise slip their minds on a busy day. Shortcuts can also be inserted into the workflow to take providers to other data or tasks they typically access or do at that point in the workflow. Taking advantage of the various workflow design engines in your EHR will speed up the workflow of providers.
Investing in EHR Personalization
In all honesty, personalization takes a fair amount of time and effort on the part of the IT or Informatics teams, and time and effort mean resources. Unfortunately, underfunding of these resources at most organizations is likely the reason personalization tools are so underutilized. This is a classic example of “penny wise and pound foolish”; organizations refraining from spending money on relatively inexpensive trainers and analysts and, in turn, leaving the most expensive personnel inefficient and unhappy.
Interested in learning how Medix Technology can supply the leadership, guidance and talent you need to accelerate the building of a successful and cost-effective physician satisfaction program at your organization? Click here to contact our team!
About the Author
Dr. Brian Patty joined Medix Technology as Chief Medical Informatics Officer in 2020. As one of the nation’s first CMIOs, he brings more than 40 years of medical and clinical informatics experience to the team. Dr. Patty partners with our clients at all stages of their Epic journey, from implementation to optimization. His areas of expertise include improving clinical workflows, simplifying EHR processes to improve end user satisfaction, reducing burnout and costly turnover, and maximizing technological investments.