May 3, 2022 - Parul Saini, Webmedy Team
As per a study, the more time a physician spends seeing and communicating with a patient, the more satisfied the patient is with the quality of care. A physician's time is often busy with many other things in today's healthcare environment. The most significant one is, arguably, electronic health record (EHR) systems and EHR satisfaction.
Using EHRs in hospitals and clinics will allow healthcare providers to deliver higher quality patient care. To some extent, that's true based on current research. Quality of care and organizational efficiency has improved as well as user satisfaction with the EHR. Physicians have acknowledged these challenges, but EHR has also brought its own set of issues. Moreover, physicians say these challenges are time-consuming and limit their ability to satisfy patients, which in turn lowers their EHR satisfaction.
Let's Understand the relationship between EHR (Electronic Health Records) and Physicians.
Many front-line physicians will tell you that they have a love-hate relationship with the EHR, according to a poll. They don't want to fully abandon technology and return to the days of paper, but the way it has affected their processes has enhanced productivity while also causing a dramatic shift in the care paradigm.
A recent survey by NCBI found that physician satisfaction with EHRs and their perception of their impact on clinical care were generally positive. But some other factors are associated with physicians like age, clinical role, and attending level that affects the physician's satisfaction.
Another study from Stanford Medicine reveals that more than 66% of physicians are satisfied with EHRs. Some other facts from the same study:
The relationship between physician use of EHR and patient satisfaction is poorly understood despite the concurrent deployment of patient satisfaction surveys and EHRs. Previous research on the impact of the EHR on physician-patient communication has been observational, describing the behaviors of physicians and patients when they access the EHR in the exam room. Clinical encounters, during which physicians access the EHR, are often marked by long pauses, with few clinicians sharing what they are viewing.
So, what can healthcare organizations do to boost physician satisfaction and reduce EHR-related burnout? According to research, the five best strategies that can have the most impact are:
Starting on the right foot is of paramount importance when it comes to EHRs. To ensure successful use of the EHR, a minimum of six hours of training and direct support must be provided within the first month. Pre and post-EHR use should involve classroom and online instruction, as well as personalization sessions. As part of a comprehensive onboarding program, physicians focus on how these tools can help them thrive as part of the care team, not just the nuts and bolts of the EHR system. Along the way, use proficiency tests and metrics to measure success and the need for further training.
Next, EHR education and support must go well beyond onboarding. Epic recommends at least four hours of training a year, structured into shorter, consumable sessions using multiple modalities. This can only be achieved with dedicated training and support from a team that understands the physician workflows in-depth. Providing at-the-elbow support while on rounds and in-clinic is crucial; continuing education regarding the EHR must be available when and where physicians need it. It is best to incorporate training into already-established departmental meetings or other team meetings regularly to ensure it becomes ingrained in the team culture.
While education is important, education cannot simply be mandated from the top. Instead, the training and development of EHR use should be a continuous conversation. Not all physicians or care team members may be comfortable communicating this way. Healthcare organizations need to offer staff multiple channels through which they can share their frustrations, suggestions, and needs. Surveys, discussion groups, department meetings, and governance are just a few options.
A healthcare system's best weapon against burnout may just be the physicians themselves! Physicians builders are key "multi-lingual ambassadors" meaning they are fluent in both the languages of EHRs and their fellow physicians. Through formal governance with physicians' representation, Peer review boards can inform analysts what they would like to see built and upgraded. When the directions come from a place of rich, personal experience, everyone benefits.
The final step is getting personal, which means engaging operational leaders and training the entire care team on more efficient workflows. If needed, delegate administrative tasks to other members of the team. Using nurses, clinic managers, and EHR vendor tools, monitor efficiency and identify problem areas. Over time, high-impact areas can be identified.
EHR functionality like patient history helps to maintain a correct and detailed history of patient interactions which provides more personalized care.
The automatic billing and claim tracking tools in the EMR software system automate end-to-end billing procedures and streamline the tracking of various claims, which ultimately helps practices to get paid faster.
EHRs help practices improve productivity by allowing physicians to keep track of patient health and information like demographics, past medical history, prescriptions, etc.
EHRs boost primary care teamwork and coordination by - (1) improving communication and (2) redefining team roles/improved delegation.
EHRs support easier task delegation and help avoid task duplication. Task manager software (when part of the EHR) and message distribution from the patient portal to providers' in-boxes are examples of how EHRs allowed such delegation.
Some practices described how EHRs allowed them to provide guideline-based care and track patients' disease markers over time. Generally, primary care practices reported such a benefit.
Patients across several specialties and practice models report that their EHRs enable them to access patient information in healthcare settings and at home, as well.
EHR-based messaging applications (e.g., patient portals) and certified medical records (e.g., providing access to other providers' notes) enhanced communication among physicians. In practices with multiple providers using the same EHR, improved communication between providers was most commonly observed.
Whether it is burnout in physicians or management time is taken away from patients to manage EHRs, these low EHR satisfaction issues pose a risk to the effectiveness of hospitals and clinics in treating their patients. Optimal EHR implementation will take years, at least. However, one should listen to what physicians have to say about the problem (and solution). Deloitte published a study in 2018 indicating that 62% of physicians want more interoperability between EHR platforms and easier ways of updating patient records. The healthcare industry doesn't control interoperability, but the EHR industry does. Efforts are being made in that direction, but hospitals and clinics must focus on domains they can control, such as implementation, maintenance, and training.
In the past, primary care providers operated inefficiently because of the manual processing involved in clinical, financial, and administrative tasks. Physicians are happier and satisfied when patients' needs are fulfilled by delivering high-quality care. EHR features and tools help to automate and streamline the daily clinical, administrative, and financial tasks which let care providers see more patients and provide better care. Primary care providers are the pillar of the healthcare system and are often overburdened so good EHR software should be easy to use, automatic, and reliable facilitating seamless communication between physicians involved in the healthcare system.
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