Providers’ dissatisfaction with electronic health records these days takes many forms. The systems are seen as burdensome from a regulatory perspective, unwieldy technologically for their nurse and doctor users and oriented more to billing uses rather than clinical or process improvements.
But it doesn’t have to be that way.
At a session during the Healthcare Innovation Southeast Summit + Cybersecurity Forum last week in Nashville, three industry professionals outlined how they’re working to shape the next generation of EHRs into tools that better serve patient care and help lift clinicians’ overall job satisfaction scores. Key to reaching those goals, they said, are not big budgets or flashy rollouts but rather broad buy-in, effective training and a little bit of bravery.
First things first, two statistics from panelist Liz Griffith, MSOD provider success manager at the Pleasant Grove, Utah-based KLAS Research: Her firm’s research of roughly 250 organizations, she said, shows that about 60 percent of doctors are happy overall with the EHR experience – which is perhaps a surprisingly high number – and that only 25 percent of user satisfaction scores can be attributed to an organization’s choice of vendor. The health systems and physician groups that are satisfied with their systems, she said, typically share the following characteristics:
- Technical mastery: The clinical teams understand the ways they can put their EHR tools to work and have been properly trained. Very important in that, Griffith added, is the initial training teams receive. Getting those first sessions right accounts for a large share of satisfaction – or dissatisfaction – and influence attitudes for years. Also factoring in here is good training (or retraining) of workers at other levels of the organization: Griffith shared an anecdote of nurses being told post-training by their shift leaders that “That’s not how we do things. We have workarounds.”
- Shared ownership and governance: Griffith said a major factor in the success of EHR (and more broadly, technology) projects is how well they align with the high-level goals of the organization. Has the C-suite bought into what the EHR is intended to achieve? Are clinical leaders on board with the stated aims? Is the IT department an enthusiastic participant in the project or a so-called “wall of no?” One KLAS client, a small health system in rural New York, raised its EHR satisfaction score by more than 30 points in one year by focusing on bettering the communication between its tech team and physician groups.
Christopher Kunney, chief of strategy and business development at software development and systems integration company DSS Inc., said project ownership should also involve vendors. Kunney likened the provider-vendor relationship to the dating-versus-marriage dynamic except that “we’re not just dating here” when it comes to medical records. Both sides should be equally committing the time and training needed to make things work as best they can. Providers, he said, should tell vendors such as his, “We need you to invest in us as much as we’re investing in you.”
- Personalization: Most clinical organizations are likely looking to emphasize different factors and features and looking to work their systems into distinct workflows. With the training mentioned earlier comes the knowledge required for clinicians to better own their success factors and customize HER systems to better serve both their and their patients’ needs.
Sometimes, it might be the workflows that need to change to allow the technology to become a more integral part of care delivery, not simply a repository for information. Panelist Owensboro Health Chief Medical Information Officer David Danhauer, M.D., said his team is focused on staying agile and making the results of its work intuitive. A broader goal for the system serving 18 counties in Western Kentucky and Southern Indiana, he said, is to put the patient’s records in the patient’s hands.
“We need to make sure we merely borrow the data,” Danhauer told summit attendees. “That’s where I think the disruptors will create real change in coming years.”
Here’s also where that bit of bravery comes in, the panelists agreed. Being nimble and adaptable and making change happen requires firstly the willingness to ask what needs to be measured and then to create benchmarks and measure against those. Danhauer said that, when he started his program, he was pretty certain his first scores would be far from pretty. But they laid the foundation for the work ahead and for progress that has fed on itself.
“If I was to grow my team, I needed to run the right reports and show satisfaction improving,” he said. “We’ve had some amazing results.... But if you’re not asking, not searching, you can’t improve or know where you could improve.”