05 Jan Do you feel like you are doing battle with your EHR?
I run across pediatricians all the time who complain that they hate their EHR. Some of them hate it because they bought the wrong product for their needs. We have heard since training that pediatric patients are not just little adults. It should be no surprise that you can’t just take an adult-focused EHR and make it work in our practices. Having a pediatric EHR can make a huge difference.
That being said, it has been my experience that sometimes physicians feel like they are doing battle with their EHR for some basic reasons that they have the power to address. Your EHR is supposed to be your tool, not your enemy. At the risk of getting blasted by my colleagues, I am going to venture out on a limb and say that some of our frustration is our own fault.
Let’s start with hardware. No matter how good your software is, if you don’t like the equipment you are using you will be frustrated day after day. If you are still in the process of researching your purchase, please pay close attention. Ask all your office personnel what kind of computers they like to work with. Do they like to type or point and click? Do they like to have a huge screen with multiple windows or use their smart phone or iPad? Don’t force someone with aging eyesight (like mine) to use a tiny device that they can’t read. Don’t expect someone who has never used the pinch gestures on an iPad to find it easy to learn new software and a new device at the same time. Consider buying a combination of products to accommodate the styles of your users. Hardware costs keep going down. Don’t buy the cheapest available products or networking. Buy what works for your practice.
Now let’s talk about setting up your EHR. If you buy a pediatric EHR, it will likely have lots of preloaded templates that have been started for you. You still have work to do!! You want to make sure that when you choose a template, you know what it says. If the templates make sense to you, you will trust them. If you trust a template, you won’t have to read every line of every template every time you use it. You want your address book populated with all of the specialists you refer to before you go live. You want to reach for that information and have it there when you need it, not have to add new information when it is inconvenient. Spend the time to set up your system thoughtfully. It saves you time every day you use it.
Work flow is a huge issue and only one that your practice can solve. As many of you have heard me say, “If you have seen one pediatric practice, you have seen one pediatric practice.” You need to ask yourself what is my office protocol for handling and documenting incoming reports, phone calls and requests? How do we confirm appointments, take new patient registrations, process “tag-a-long” patients or emergencies? How do we notify staff of a vaccine order, throat culture or a nebulizer treatment? Hammer this out before you implement your EHR, because there will be new work flow protocols to establish (such as scanning old records, importing labs, etc.) If you don’t already have these written down, do it now! There is no better way to find out just how (in)efficiently your office is functioning.
Establish your work flow, choose an EHR product that supports it, then be prepared to evaluate how it fits and change what you need. If things aren’t working, find out why. Breakdown the steps. Identify the barriers, then work to address them. This is not a destination, it’s a journey. You can choose to complain, or create your own solutions that work for you. Most of us in medicine don’t like change. Remember you can’t create a culture of continuous quality improvement without change. If you keep an open mind as you adopt technology in your practice, you can begin to create your own positive change for your practice and your patients.