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Reimagined EHR knowledge hub

Realize the benefits of a reimagined EHR and how it can help you improve efficiency and care.

5 Components of Successful EHR Design

Here’s what a reimagined, physician-focused EHR should look like:

1. Easier documentation that makes sense

Physicians should be able to document in a way that naturally communicates the patient’s story, rather than follow a series of checkboxes for data input. In an improved EHR experience, documentation should be a way for physicians to communicate clearly to themselves, other providers, and patients.

Built-in shortcuts and search intelligence should keep documentation work to a minimum, giving the physician more quality time with the patient. To make documentation as rapid as possible, good EHR design should include intelligent shortcuts to:

  • Optimize efficiency
  • Save time by eliminating unnecessary, repetitive typing
  • Help the physician focus on the patient instead of the screen

Physicians should be able to enter free text, by either typing or using a speech-to-text tool. Templates should be available if that’s preferred. But a reimagined EHR design should emphasize free text as the most efficient way to produce a simple, clear narrative.

“Accelerators” are one example of built-in search intelligence that can make documentation easier. Here’s how accelerators work: As a particular problem is documented, the EHR offers a series of options that the physician is most likely to enter next. Instead of typing, the physician simply selects an option. For instance, when the physician enters a diagnosis, the EHR automatically recommends the common orders and medications associated with that diagnosis, available for the physician without typing. These options have been “learned” based on the previous behavior of the physician, the practice, and providers across the cloud-based network, as well as the patient’s history.

2. Intuitive design

From banking to travel to grocery shopping, we are already familiar with how online tools work, and how they can improve our day.

With that in mind, an EHR should be as intuitive as the best consumer applications, to be as easy to use as any well-designed app or website. That way, any provider can easily discover and understand features, and start using the system right away.

Take ordering, for example. Clinical staff and providers should be able to order as they go, whenever it’s most convenient or appropriate to the encounter. Orders should accumulate in an online “shopping cart,” with a single place to “check out,” where a physician can sign off on the orders. This intuitive approach is just like the way “ordering” occurs just about everywhere else in our online lives.

3. Patient-centered view

A modern EHR design should keep the patient story front and center at all times. Physicians and clinical staff should be able to easily find the details they need.

One way this can happen is by boiling down dense patient information to an essential narrative for the physician. During the exam, the patient’s story should be designed as a clear, chronological view that shows an immediate snapshot to the physician. This eliminates the need to search for last visit’s information or today’s vitals.

Telling a concise, sensible story has enormous value. When patient information is plainly conveyed, as with the old index card system, it’s instantly understandable to all providers across the continuum, as well as the patient.

4. Smart delegation that keeps work out of the exam room

Strong EHR design should direct work away from the exam room whenever possible, so the physician isn’t burdened with tasks that don’t make good use of his or her time.

First, a good cloud-based services provider should be able to handle work on behalf of providers. This moves tasks not just out of the exam room, but also out of the practice. Next, a redesigned EHR workflow should determine which tasks patients can do—reviewing and updating their health information before a visit is a perfect example. Then, the EHR workflow should move clinical in-office tasks to nurse practitioners, medical assistants, and other staff. The physician should be doing work that only a physician can.

This approach has distinct advantages for meeting quality measures. A cloud-based services vendor should be able to find relevant clinical measures for your providers, identify where in the workflow each can be met and recorded most easily and with the least disruption, and the most appropriate staff member to be the recorder.

For example, a color-coded visual alert could remind clinical staff to record a patient’s medications during intake. This satisfies a core Meaningful Use measure before the patient even walks into the exam room. In another example, the physician doesn’t have to manage all orders, and can permit nurses to request common orders throughout the workflow; the physician then easily signs off on orders at the exam’s end.

5. Constant improvement

Industry requirements change far too often for a static EHR. By thinking of the EHR as an evolving, responsive service, an important shift can take place—one where the EHR is not a source of frustration but delivers relevant, purposeful information in a way that satisfies its users.

With cloud-based software, developers can track the way it’s used and adjust the workflow to benefit those that use it. Health care providers get an EHR that’s never “completed” but, rather, one that gets continually better and smarter.

If a process doesn’t flow well for physicians, for example, the cloud-based vendor will know about it. And they’ll work to update it. Developers identify when a majority of providers are having difficulty at a point in the workflow, and then make changes to address that problem. This flexibility in EHR design is a valuable attribute of cloud technology, and a necessity for EHRs to continually respond to industry changes and physician needs.

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