Oncology & Hematology Coding Alert

Stay ahead of updates, keep up patient interactions, and keep track of issues.

Providers who have adopted electronic health records (EHR) may now face challenges when incorporating new system updates. While the use of an EHR may have been a welcomed change initially, it has now led some to believe that it hasn’t worked out to be as cost-effective and efficient as first anticipated. However, if adopted well, EHRs may still hold promise for future.

The American Medical Association (AMA) and American EHR Partners performed a joint survey asking physicians about how satisfied they are with their EHR systems, and the results were surprising. Compared to doctors’ responses to similar questions in 2011, “more physicians are reporting being dissatisfied or very dissatisfied with their EHR system,” American EHR said in an Aug. 10 summary of the report.

In summary, among the 940 physicians who completed the survey, a startling 72 percent said they found it difficult or very difficult for their EHR system to cut down on their workload, and another 42 percent of doctors “thought their EHR system’s ability to improve efficiency was difficult or very difficult,” American EHR noted.

Surprisingly, the organization found that 22 percent of practices are satisfied with their EHR system—a significant drop from the 39 percent of doctors who were satisfied with their systems just five years ago.

Compounding physicians’ frustration was the fact that the EHR systems are tough to use, in addition to being quite costly for medical practices. Some 54 percent of doctors polled “found their EHR system increased their total operating costs,” the report added. This appears to contradict what some physicians believed, since many EHR vendors indicated early on that using an electronic record would actually cut costs.

Take These 3 Tips to Heart

If you, like the physicians polled, are finding it harder to keep up with your EHR as time marches on, consider the following three tips to help you make the most of your electronic health record system.

1. Stay Ahead of EHR System Updates

You’ve learned the nuances of your EHR and trained your staff on how to use it—only to find that an automatic update loads overnight and your entire staff is once again in the dark about how to use the system. Unfortunately, this is a common problem—and one that can be avoided with careful pre-planning.

The best bet is to “take a more gradual approach for updating the system,” said the Office of the National Coordinator (ONC) with HealthIT.gov in a tip on its website. “Try to keep changes to a minimum. Introduce system changes in versions (phases) and allow sufficient time between changes for staff to adapt to the new system.”

This means that you should talk to your vendor about how often updates can take place in your system, and whether you can schedule them rather than having the software automatically update unexpectedly. This would allow you to test the updates ahead of time so you can effectively train your staff on how to handle them. For example, if an update appears to wipe out a patient’s prior medication list, you can find the problem and see whether the medication list is simply “hidden” within the EHR, and then train the physicians on how to un-hide it after the update takes place.

Bottom line: Your EHR vendor should communicate and share scheduled system updates in advance and as frequently as necessary. In this way, everyone has an opportunity to prepare, know ahead of time when the updates are expected, and what the updates include.

2. Keep a Log of Issues

The best way to fix problems within the EHR is to maintain an issues log, the ONC advises. Whether you encounter software glitches, missing information, unreadable notes or other concerns, assign/identify one central person in your organization where EHR users can go to report issues. That person should keep a running log of issues, which can then be reported to the vendor or the organization’s IT leadership for remediation.

You can also keep a list of corrective actions in the log indicating how previous issues were corrected. That way, if another practitioner encounters the same problem in the future, they can look back at how the issue was corrected previously and implement the same response and solution to remediate the issue.

3. Maintain Patient Interaction

One frustration of EHR use is that doctors often find that burying themselves in an EHR system can help them access patient information, but may hinder them from having meaningful interactions with patients, the ONC found. For instance, the government says, “physicians might get so wrapped up in simply filling in all the checkboxes on an EHR form that they don’t take the time to ask their patients open-ended follow-up questions.”

One way to overcome this issue is to strategically place your EHR workstation in a place where the doctor can continue eye contact with the patient, the ONC advises. “The clinicians should also engage the patient when they are reviewing relevant sections of the EHR, such as the problem list, or patient education materials,” the ONC advises.

If your doctor is using a tablet, for instance, she can place it on the table between her chair and the patient’s — that way, the doctor will check a box, look up at the patient to ask follow-up questions, and then look back down at the EHR. This is more interactive than keeping the EHR on a desk that requires the doctor to turn her back on the patient to check the boxes.

Resource: To read more about the AMA/American EHR study, visit www.americanehr.com/research/reports/Physicians-Use-of-EHR-Systems-2014.aspx.