Feel like your EHR system is a sputtering old jalopy? There’s a 50/50 chance it’s a high-performance machine you haven’t fully optimized. Many practices think they need to ditch their old systems to solve their EHR problems, but they may well have a “Ferrari sitting on blocks,” says MGMA presenter Taraq Mazher. If you determine you’re better off staying with your current EHR system, here are the first steps to a tune up.
1. Get broad input from all of the people who work in your practice. Usually there are one or two squeaky wheels who can’t wait to catalog everything that’s wrong with the EHR. What this small sample says may be the truth, but it’s only a sliver of the truth. To get a full, true picture, you need input from everyone in multiple roles—clinicians, back office, front office—about what’s working well and what’s going wrong. Mazher and co-presenter Michelle Holmes suggest you use a survey to gather data about each user’s experience. You can find sample questions for each phase of EHR use/implementation here.
2. Form a steering committee. Here’s what happens at many practices. One clinician is unhappy and wants “just one little change.” He goes to the IT guy one-on-one and gets it done. Too many non-centralized, one-shot changes and you end up with an EHR held together with wire and duct tape that no one can navigate well. It’s been “customized” for everyone and therefore works for no one. To optimize your EHR, you must set up an organizational structure that gets input from everyone, but implements changes only if they make sense for everyone.
3. Find a physician champion. Your typical clinician would rather drop a bowling ball on his foot than think about EHR. But most practices have one physician who’s technically savvy and wants to think about it, says Holmes. Get that doctor on the steering committee so s/he can get input and cooperation from physician peers. Compensate the physician for time spent away from patients with proxy RVUs, Mazher suggests.
4. Break up your training into small chunks. Give each short training session a takeaway gem that immediately makes the user’s EHR experience easier. If your practice is on the larger side, consider easy-to-schedule repeats. Mazher has successfully offered the same 20-minute lunch-and-learn topic several times in one week, giving EHR users plenty of opportunities to pop in for a quick shot of training.
5. Over-communicate. Most practices find that their EHR users are frustrated because they never really learned how to use the system in the first place. Once it’s time to retain, use multiple channels to get your message across. Tailor your messages to different learning styles. For example, internal websites or emails help some people learn, but lots of physicians never look at that stuff. So supplement these materials with your lunch-and-learns and with paper flyers that you post in clinician areas.
