Five Recommendations for Fixing Flawed EHRs

By David Lareau, CEO, Medicomp Systems
Twitter: @MedicompSys

Long before Fortune Magazine and Kaiser Health News published “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong”, health IT insiders have recognized that EHRs are flawed and not yielding the quality care improvements and cost savings that futurists forecasted 20 years ago. In fact, rather than enhance patient care, the shortcomings of these systems often compromise patient safety and diminish physician satisfaction.

We’re now in the thick of a blame game battle, with fingers pointing at every stakeholder, including the government, EHR vendors, health systems, and clinicians. Regardless of who’s at fault and how we got here, it’s time for all parties to join forces, quiet the critics, and make the meaningful changes required to make healthcare better.

As we consider the strategic alternatives, I recommend we include these 5 elements:

  1. Empower clinicians. We must provide clinicians with tools that are designed to accommodate – and not hinder – their workflows. The most powerful computer in any treatment room is the clinician’s brain – and it’s essential that we give clinicians the time and mental space to actually think about the patient in front of them, rather than forcing them to sift through pages of electronic data.

We need to revamp existing systems so that clinicians can find all the relevant clinical information on individual patients, at the point-of-care, within a click or two. With ready-access to a patient’s complete record, clinicians are empowered to confidently deliver safe and effective patient care. With more efficient tools, we can help drive greater clinician productivity and eliminate many of the inefficiencies that are fueling clinician burnout.

  1. Implement penalties for data blocking. Without the elimination of data blocking, we cannot successfully bend the cost curve, make healthcare safer, and improve patient outcomes. Clinicians must have access to patients’ complete clinical records, and, if necessary, we must impose stiff financial penalties on vendors and providers who are more concerned about protecting market share than making healthcare safe and efficient.
  2. Seek clinician input. We can longer assume that clinicians will adapt to prescribed workflows. Instead, we need to ask clinicians what modifications they need to existing systems to make them more efficient and provide them with the right information at the right time. By incorporating clinicians’ recommendations for system design and workflows, EHRs can be optimized to improve patient care and physician productivity – which will also enhance clinician satisfaction.
  3. Provide customizable workflows. One size does not fit all when it comes to EHR workflows. A specialist, for example, has very different needs than a primary care physician. We need to provide users with flexible designs that support the filtering of information in ways that support an individual physician’s thought processes and deliver the right data for the right patient at the right time.
  4. Take advantage of app-based solutions. Despite the imperfections of EHRs, few health systems have millions of extra dollars to buy replacement systems. Implementing an EHR is not only expensive, but also creates disruption across the organization. Providers wanting to expand the usability of their systems should consider the wide variety of app-based solutions that can now be incorporated into legacy EHRs using established standards such as FHIR. Many of these technologies are designed to fix inefficient workflows that diminish physician productivity. Others focus on organizing existing data so that clinicians can easily access the data they need on demand – even if that data is coming from an outside system. Other app-based solutions enable more complete and accurate documentation to facilitate quality care, correct reporting, and better clinical and financial outcomes.

“Death by 1,000 Clicks” focused a harsh spotlight on the many ways EHRs have failed to live up to their full potential. Now it’s time to move forward, fix the flaws, and deliver solutions that advance the delivery of quality patient care.