A recent webinar highlighted key thoughts and reflections on how to adopt electronic health records without losing physician productivity. The webinar featured speakers William Edwards Jr., MD, of the Surgical Clinic in Nashville, Tenn., and Alex Poston, president of Entrada, a clinical documentation and data management solutions company.
The webinar started with Mr. Poston explaining why the issue is a particularly relevant topic in the healthcare industry today. There are certain challenges tied to EHR conversion, especially as the patient population continues to grow organically and the number of healthcare providers is not projected to increase as quickly. This is exacerbated by the recently passed healthcare reform, which will drive up to 32 million more people into the insured ranks, as well as productivity pressures inherent in the adoption of EHR systems and the upcoming meaningful use reporting. As a result, it is critical to explore implementation models that support physician and administrative productivity and efficiency.
Mr. Poston explained that four of the main challenges of implementing EHRs include:
• the need to maximize productivity;
• the need for timely chart completion;
• the need to manage data and reduce the number of lost records; and
• the need to control administrative and technology costs.
Traditionally, physicians carried out clinical documentation by manually calling and dictating clinical notes. However, even with the implementation of an EHR, physicians are finding themselves spending much of their time going through the process of electronically documenting clinical notes, so a different and better approach is necessary, Mr. Poston says.
Dr. Edwards, who currently uses an EHR at his clinic, says the way in which information is transmitted from the physician's mind to the EHR is the reason for productivity loss. "The challenge in using EHRs is interfacing the technology with physicians so they can do their daily work without loss of productivity," he says. "The goals for our ambulatory EHR was to minimize workflow disruptions, accomplish access issues by allowing simultaneous access across multiple sites, mimic the physicians' workflow and set up electronic records to replicate the look and feel of paper charts."
Upon EHR deployment, Dr. Edwards says his clinic came across a problem with mistaken identities caused by physicians entering chart numbers incorrectly, transcriptionists typing chart numbers incorrectly and filers filing documents incorrectly. In order to remedy these inefficiencies, several methods can be adopted in order to minimize the number of human touches, which Dr. Edwards says could potentially cause more mistakes. Those methods include drop-down boxes with point-and-click, free-text typing, traditional dictation and desktop voice recognition. However, all of these options created significant productivity declines for a busy surgical practice and were unacceptable for his group.
Healthcare providers must be cautious when using desktop voice recognition as a means of electronically documenting clinical information. Although the software allows users to speak into a microphone to dictate information, often that same user is responsible for editing the information. It would greatly benefit healthcare providers if a system was deployed which would automatically assist in as much of the process, including editing, as possible.
At Surgical Clinic, this issue was addressed by interfacing the documentation platform (which included a back-end voice recognition system) with the scheduler system so that jobs were being generated based on that day's schedule of patients and each physician's preferences. "For example, if I want to dictate history and physical notes for all my medical charts, those jobs [for each patient I would be seeing that day] would be sitting there," Dr. Edwards says. Interfacing the systems also helped the issue of mistaking identities of medical charts, as the electronic system automatically stamps each queued job with demographic information from the scheduler system.
Dr. Edwards says the success of an EHR is inherently tied to whether healthcare providers adopt an efficient data entry method, one that minimizes the incidence of mistaken identity and information which can be prevented by automating as much of the process as possible.
Other keys to efficient chart completion include the following:
• Provide multiple options for the physician to document encounters.
• Embrace mobility and adopt mobile devices and tablets or PCs as tools in the EHR process.
• Eliminate manual dictation options.
• Work hard to automate documentation throughout the chain to eliminate human touches.
• Automate document review and multi-distribution (i.e. allow hospitals, surgery centers and physicians share relevant documentation for billing and chart completion).
Download the webinar presentation by clicking here (pdf).
View the webinar by clicking here (wmv). We suggest you download the video to your computer before viewing to ensure better quality. If you have problems viewing the video, which is in Windows Media Video format, you can use a program like VLC media player, free for download here.
Learn more about Entrada.
The webinar started with Mr. Poston explaining why the issue is a particularly relevant topic in the healthcare industry today. There are certain challenges tied to EHR conversion, especially as the patient population continues to grow organically and the number of healthcare providers is not projected to increase as quickly. This is exacerbated by the recently passed healthcare reform, which will drive up to 32 million more people into the insured ranks, as well as productivity pressures inherent in the adoption of EHR systems and the upcoming meaningful use reporting. As a result, it is critical to explore implementation models that support physician and administrative productivity and efficiency.
Goals and challenges
Mr. Poston explained that four of the main challenges of implementing EHRs include:
• the need to maximize productivity;
• the need for timely chart completion;
• the need to manage data and reduce the number of lost records; and
• the need to control administrative and technology costs.
Traditionally, physicians carried out clinical documentation by manually calling and dictating clinical notes. However, even with the implementation of an EHR, physicians are finding themselves spending much of their time going through the process of electronically documenting clinical notes, so a different and better approach is necessary, Mr. Poston says.
Dr. Edwards, who currently uses an EHR at his clinic, says the way in which information is transmitted from the physician's mind to the EHR is the reason for productivity loss. "The challenge in using EHRs is interfacing the technology with physicians so they can do their daily work without loss of productivity," he says. "The goals for our ambulatory EHR was to minimize workflow disruptions, accomplish access issues by allowing simultaneous access across multiple sites, mimic the physicians' workflow and set up electronic records to replicate the look and feel of paper charts."
Automating the surgical clinic through an efficient and effective EHR
Upon EHR deployment, Dr. Edwards says his clinic came across a problem with mistaken identities caused by physicians entering chart numbers incorrectly, transcriptionists typing chart numbers incorrectly and filers filing documents incorrectly. In order to remedy these inefficiencies, several methods can be adopted in order to minimize the number of human touches, which Dr. Edwards says could potentially cause more mistakes. Those methods include drop-down boxes with point-and-click, free-text typing, traditional dictation and desktop voice recognition. However, all of these options created significant productivity declines for a busy surgical practice and were unacceptable for his group.
Healthcare providers must be cautious when using desktop voice recognition as a means of electronically documenting clinical information. Although the software allows users to speak into a microphone to dictate information, often that same user is responsible for editing the information. It would greatly benefit healthcare providers if a system was deployed which would automatically assist in as much of the process, including editing, as possible.
At Surgical Clinic, this issue was addressed by interfacing the documentation platform (which included a back-end voice recognition system) with the scheduler system so that jobs were being generated based on that day's schedule of patients and each physician's preferences. "For example, if I want to dictate history and physical notes for all my medical charts, those jobs [for each patient I would be seeing that day] would be sitting there," Dr. Edwards says. Interfacing the systems also helped the issue of mistaking identities of medical charts, as the electronic system automatically stamps each queued job with demographic information from the scheduler system.
Key considerations
Dr. Edwards says the success of an EHR is inherently tied to whether healthcare providers adopt an efficient data entry method, one that minimizes the incidence of mistaken identity and information which can be prevented by automating as much of the process as possible.
Other keys to efficient chart completion include the following:
• Provide multiple options for the physician to document encounters.
• Embrace mobility and adopt mobile devices and tablets or PCs as tools in the EHR process.
• Eliminate manual dictation options.
• Work hard to automate documentation throughout the chain to eliminate human touches.
• Automate document review and multi-distribution (i.e. allow hospitals, surgery centers and physicians share relevant documentation for billing and chart completion).
Download the webinar presentation by clicking here (pdf).
View the webinar by clicking here (wmv). We suggest you download the video to your computer before viewing to ensure better quality. If you have problems viewing the video, which is in Windows Media Video format, you can use a program like VLC media player, free for download here.
Learn more about Entrada.