While all of these complaints are legitimate, especially depending upon where a hospital is in the road to utilizing a full EMR, merely complaining about the problems will not improve EMR implementation, or make the problems go away. Instead of pointing out what is wrong with EMRs, Carl Medley II, cofounder of re_group, a change management consulting and training firm, believes the healthcare industry needs to put criticisms on EMR performance to constructive use.
Here Mr. Medley discusses four tips that could lessen and even prevent the common EMR complaints of lowered productivity, disrupted workflow and training gaps.
1. Don't assume there will be no impact on productivity. Often, there is an underlying assumption that EMR implementation will have no impact on the productivity of physicians and hospital staff. According to Mr. Medley, when this assumption is made expectations are built around it, laying the groundwork for frustration.
"We know [EMRs] will increase efficiency, but we don't acknowledge there will be a lag — that there will be a period of time where the staff is less productive than they were. More needs to be done to tell the staff that there will be a period of time where they can expect to be busier and be less productive, that is what happens during the learning curve" says Mr. Medley. "They can't have a false expectation that everything will run smoothly right out of the gate because it will not happen."
2. Utilize additional resources during transition. According to Mr. Medley, it is important to acknowledge that an EMR implementation will create additional work for the hospital and the staff. This may necessitate utilizing additional resources or hiring temporary staff to accommodate learning curves with the system's interface and resulting productivity losses.
"During [an EMR implementation] you live with a foot in both worlds. Half [of the hospital] operates in the old way and half has the advantages of the EMR's new capabilities and technology," says Mr. Medley.
However, issues of real productivity loss and perceived frustration can be partially augmented by additional resources, says Mr. Medley.
3. Clearly articulate changes, set expectations accordingly. While additional resources can help, hospital executives need to clearly articulate changes that the hospital will incur and set expectations for the EMR accordingly, says Mr. Medley. Without straight-forward, honest communication about the EMR, expectations may be unrealistic, setting the stage for disappointment among staff and physicians, which could lead to complaints and dissatisfaction with the EMR overall.
For example, many physicians are accustomed to using paper charts kept in folders and dictating notes. After visiting with a patient, the physician would hand off the folder to a nurse or other hospital staff member who would complete the paperwork. According to Mr. Medley, EMRs are asking physicians to change this process. They need to complete the patient's chart on the EMR themselves, which adds a great deal of work they did not always deal with prior. This extra work must be done and kept current, or else backlogs begin to build up, and backlogs are real thieves of productive capacity.
"It is important to clearly articulate this change to the physicians and staff upfront. The expectation for a change in workflow, work level and productivity — at least for some time — needs to be understood," says Mr. Medley. "It is about giving [him or her] the mental permission to accept a lower productivity level, knowing that it will be significantly improved in the not too distant future."
4. Take your time. According to Mr. Medley, the complaint about a lack of training with EMRs can be a double-edged sword as it may involve the amount of training as well as physicians' and staff members' openness to accepting the changes. Regardless, greater value does come from hands-on training at a slower pace with the application of real-world experiences. According to Mr. Medley, success with training will vary person-to-person based on the format. Giving individuals more time to learn the interface and interact with the EMR is extremely valuable.
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