Clinicians are among the most highly trained knowledge workers in any industry, yet the systems they use to care for patients hinder their ability to deliver care. Electronic health records (EHRs) require clinical users to spend too much time searching for clinically relevant information for a given patient and, once that information is located, to go through too many disconnected processes to complete their work. In short, EHRs need to be more of a tool for patient care, and less of a burden.
Clinicians know what they want to do but can’t find the information they need without clicking through multiple screens because patient data is separated into different silos: diagnoses, labs, medications, symptoms, history, and orders are typically located in different sections of the EHR.
If a user wants to see the status a specific condition, such as diabetes, they need to see what has been done previously, along with the status and recent trends of key clinical indicators for diabetes (such as A1C levels), and to take appropriate action including documentation, compliance with quality measures, orders, and any other actions required.
With a clinically efficient EHR , each interaction with the system should provide usable, actionable information to the user at the point of care. By selecting a problem from a problem list, a user should be presented with a profile of the key indicators for the given problem, including relevant medications, lab orders and results including trendlines, related history and physical exam indicators, and therapeutic interventions for the problem. The status of quality measures related to the problem and appropriateness of diagnostic coding is also needed.
Displaying this relevant information is critical but, to make the system a viable tool for patient care, users must be presented options to complete their work. If a key quality measure needs to be completed, the system must present the information required to complete the measure without forcing the clinician to search for it. If additional documentation is required to meet value-based care requirements, the system should present that to the user without the user having to ask for it.
The bottom line: Clinical users need to be able to focus on the patient and spend less time struggling with the EHR.
Phoenix Children’s Hospital has taken this approach to another level. They met with their ambulatory providers in each department and have developed clinically specific dashboards for each specialty. A key part of their design approach involved meeting with doctors, nurses, patient care coordinators, and other therapists to determine what specific information was needed at-a-glance, and how to connect that to providers’ workflows so that everything could be completed at the point of care. By doing so, they have improved clinical outcomes, increased throughput, and achieved higher patient and clinical satisfaction.
While EHRs are often viewed as crucial clinical tools, most were originally designed to facilitate billing operations. By incorporating clinically responsive workflows that readily present the right information to clinicians at the point of care, they can fulfill their mission to drive better patient care.
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