After graduating from nursing school way too many years ago and devoting the majority of my career to healthcare IT and informatics, I can still recall a few key items from my freshman introduction to nursing classes. Beyond being able to reliably recall at least 60 percent of the bones in the human body, Maslow’s Hierarchy of Needs has always stuck with me. It is a simple but powerful graphic underscoring the requirement that basic needs have to be met before you are able to focus on growth and achieving full potential. This concept neatly encapsulates the journey we are on as we implement, maintain and optimize with the EHR user in mind.
Rather than self-actualization, I would argue that our goal is to seamlessly integrate technology into our clinician’s practice, allowing them to more effectively meet the needs of their patients. Obviously, this is a simplistic representation of our goal and does not include safety, regulatory requirements, payor requirements, standards of care and the thousand other factors that influence our approach.
To achieve this goal, we will need to further explore our EHR user hierarchy of needs, starting from the base level and building upwards.
Level 1: EHR Foundation
Before focusing on user efficiency and satisfaction, it’s important to cover the basic needs. First and foremost, the EHR needs to be configured to meet the needs of the users. Initial implementation with operational involvement and a continued focus on upgrades and optimization are essential. In addition, hardware and third-party software must be evaluated to ensure the basic needs of the users are met. This often means investing in high resolution monitors, scanners, single sign-on, transcription and other tools designed to improve basic system use.
Level 2: Organizational Support
Organizational policies, procedures and standards of care are often overlooked when focusing on configuring and training EHR users. These resources are essential to ensuring consistent, efficient use of the EHR Foundation. Policies and procedures need to provide a roadmap on using EHR functionality and other tools to meet the operational requirements of the organization.
Level 3: Training and Support
Training needs to encompass the core EHR functionality, workflow, hardware, third-party tools and organizational policies and procedures. This comprehensive approach ensures that all users have a clear understanding of what needs to be done, how it should be done and the tools that are provided to assist in completing it. Training cannot focus on onboarding alone; it needs to include ongoing training for all users. Individualized support and personalization are also needed to ensure that all users are equipped to efficiently perform their individual tasks.
Level 4: Shared Ownership
A stable system, clear policies and well-trained users combine to cover the basic needs of EHR users and organizations. However, to truly maximize the efficiency and effectiveness of your organization, it’s necessary to continue your evolution. Promoting a sense of ownership starts with including end user input in governance. Including superusers, clinician builders or other frontline employee representation in your governance and change management groups will ensure balanced decision making that reflects the unique perspectives of both IT, operational leadership and end users.
Level 5: Seamless Integration into Routine
Finally, you’ve ascended through the hierarchy of needs and are ready to reap the benefits of seamlessly integrating technology into your clinician’s practice and allowing them to more effectively meet the needs of their patients. Unfortunately, your organization is not a static environment. Time, attention and support will be needed to continue to meet the dependent needs of your users. Without constant attention your users will be, in the words of INXS, “falling down the mountain, end up kissing dirt.” However, the gains in user efficiency and satisfaction will be worth the effort.
Are you ready to optimize your EHR to better support clinicians and patients? Medix Technology is ready to help with KLAS-rated solutions tailored to your needs.
Jason Kulaga, Practice Director – Healthcare Solutions, joined Medix Technology to focus on leading and growing the consulting and advisory services practice. He is a PMP certified registered nurse with 25 years of experience in healthcare, including 4 years working at Epic in clinical implementation and 15 years overall experience in EHR implementation, project management, delivery oversight, and consulting leadership. Jason is focused on mentoring and advising internal consultants and Medix Technology clients on implementation planning, project management, community connect, interoperability, workflow, and system optimization, change management, project governance, and physician adoption.