More than a decade ago, President Obama signed into law the American Recovery and Reinvestment Act. The legislation contained hundreds of billions of dollars in new government spending meant to counter the effects of the Great Recession, which was ravaging the American economy. One key component of this legislation included a mandate that all public and private healthcare providers adopt electronic medical records (EMRs) for regular use.
The goal of this new mandate was to improve the efficiency and delivery of medical care. Since the Recovery Act passed in 2009, EMR utilization within medical practices and hospitals has increased dramatically, and results are mixed. Digitizing healthcare information creates a way to collect and organize large amounts of patient data, which offers tantalizing new opportunities for researchers. However, providers have yet to realize improved efficiency through EMR usage. In reality, this technology has made the provider's day-to-day work less efficient and more stressful.
While the intended benefits of the mandates haven't yet come to pass, EMR technology is here to stay. As a result, every provider needs to find ways to leverage the EMR's value, while minimizing their deficiencies. This approach will benefit both your patients, as well as your practice. Here are three strategies you can use to help turn the EMR into a positive for you.
The most significant criticism of the EMR is the effects it has on the patient and physicians. A recent study found that doctors spend an average of 16 minutes and 14 seconds using the EMR for each patient they saw. That's one minute and 14 seconds longer than the average appointment slot. So, the average doctor is spending their entire appointment focused on entering patient health data into the EMR rather than focusing 100% of their attention on the patient. Other research shows that for every hour a physician spends with a patient, they spend another two hours updating paperwork. This new normal leads to decreased patient satisfaction and increased physician burnout from more demanding data entry duties and less 1:1 interaction with their patients.
However, there's another side to this coin. When doctors use EMRs well, they synthesize patient health data into an accessible, central place that improves physician communication and leads to a clearer understanding of the patient's health. This, in turn, leads to better decision-making and, sometimes, better patient interaction when the physician is fully up-to-speed on everything happening with the patient's care.
So, rather than focusing on how EMRs inhibit care, physicians can work on maximizing what the technology does best. By customizing EMR features to improve provider workflow and determining how best to use the technology on a day-to-day basis (like using medical scribes to provide documentation assistance), physicians can transform this technology from a liability into a valuable asset.
Accuracy of data entry and patient care are also crucial concerns with EMR use. Many physicians are required to split their time between patient interaction and data entry, which makes it easier to commit errors. Also, many EMR systems function in ways that make mistakes more likely. These factors combine to make EMRs themselves a potential risk to patient safety.
To combat these factors, researchers have examined strategies for preventing EMR errors and made a few recommendations. These include establishing regular IT group meetings that are responsible for monitoring EMR issues that could impact patient care. In addition, standardizing the way data is formatted within the EMR can significantly improve how the information is used and understood. This could include paying attention to how decimals are written (0.5 versus .5) or using tall-man lettering to distinguish similarly-named drugs. Consistently highlighting abnormal lab results can also help providers flag essential follow-up items.
That standardization shouldn't come at the expense flexibility, however. Many EMRs default to structured entries when it isn't always necessary. One report found that 91-93% of the information entered into structured forms could be captured through another method, like dictation, transcription, and free-text entry. Users should modify their systems through vendor technical support to allow for more flexibility in capturing descriptive details.
Patient data errors are a severe concern for physicians. Unfortunately, EMRs can propagate these errors on a scale not possible with paper charts. A University of California, San Francisco Medical Center study found that physicians frequently copy-and-paste notes within the EMR. The data found that 80% of data in progress notes are either carried over or imported by providers, and only 18% of text were entered manually. If that copy-pasted information contains errors, it can introduce errors into the system and carry over into multiple data entries.
To avoid these documentation errors, physicians can use medical scribes to handle data entry responsibilities. When the task of documenting a patient encounter falls to someone who can immediately record information with accuracy, physicians no longer need to copy-and-past data, thereby reducing errors.
Despite its inherent challenges, the EMR is a part of our healthcare system now. It's essential to understand the limitations of these systems, but that understanding shouldn't obscure the advantages digital health records offer. The trick is optimizing their usage, so they deliver maximum value while minimizing interference with patient care.
Scribe-X can help. We provide trained scribes — working on-site or remotely — who enter the patient encounter directly into the EMR during the appointment. Physicians who work with scribes spend more of their time caring for their patients and less time doing data entry tasks. There's also strong evidence that medical scribes can help improve physician satisfaction and reduce burnout. If you'd like to learn more about we can help your practice, contact us today. Working together, we can transform your relationship with the EMR, so it delivers for your practice and your patents.