These days, almost every pediatric practice uses an Electronic Health Record (EHR). But how many practices use their EHR to its full extent? How many practices are aware of and engage with all the features and functionality an EHR provides?
A good EHR is more than the software on your computer – it's also the vendor behind that software. Your EHR vendor typically offers services and opportunities that extend beyond the software you are using – do you take advantage of them?
In this post, we'll share 7 ways you're underutilizing your EHR – both your software and your vendor – and how engaging more proactively with both will further the success of your practice.
1. You're not staying up to date with your vendor's EHR functionality. According to Chip Hart, PCC's Director of Pediatric Solutions, not keeping current with your vendor's newest functionality is the leading cause of EHR underutilization. EHR vendors constantly update and improve functionality in their software releases. As a result, a new version of the software is rolled out, and people aren't aware of the new improvements and tools at their disposal. Features that will help with workflow can go unnoticed and unused for months when users aren't aware of what their vendor is releasing.
The first and last thing I'd tell people is to take the time and sit down with your EHR vendor's latest documentation and release information, learn about it, and see what it is you are missing out on.
Whether it's watching a training webinar over a lunch and learn session in your office, making sure to check the latest news items from your vendor, or taking time to look at the documentation and videos that typically accompany each software release, staying informed so that you can use your EHR to its fullest potential is imperative.
2. You're not taking advantage of your EHR vendor's training opportunities. A good EHR vendor will provide more than just software. They will also provide the training and support you need to excel in your practice. Some of the resources to look for in a vendor include:
- an annual Users' Conference
- frequent webinars or web labs related to software functionality and practice management education
- individual consulting specific to your practice's needs
- an excellent support department that can train you and assist with big picture projects in addition to solving specific issues that arise
When you don't take advantage of the constellation of additional resources offered, you are underutilizing what your vendor has to offer.
3. You're not streamlining your workflows. Think of your EHR as the house you're going to be living in every day. You want it to suit your style. Of course, the generic version works well enough, but one thing people don't do enough is to put a price tag on the reward they'll receive by tailoring the system to their preferences.
A common argument is that there is no time to configure the software. However, one of the reasons time is short is that workflows are not streamlined, so tasks take longer to complete.
The best EHRs augment the aspects of your patient flow that are efficient and effective. They don't support a bad patient flow. They are not designed to make you do something poorly, faster. Too many people fall into the trap of thinking, "but this is how we've always done it." However, if adapting to a new workflow is to your overall advantage, it is worth considering making the shift.
If you're not confirming that orders are matched with the correct codes and billed properly, if it takes you too long to room a patient, or if you're paying staff to do things that your EHR can do for you, you are experiencing symptoms of EHR underutilization. These are just a handful of the ways that the features of an EHR can be put to use to streamline your daily workflows.
Some of the ways you can learn how to streamline your workflows include:
- learn how other people are using the same software to solve the same problems - visit another practice and see how they are using their EHR
- start a conversation on your vendor's mailing list
- talk to peers at conferences to hear how they manage workflows
- attend your vendor's Users' Conference to learn best practices for using your EHR software
There are all kinds of ways to streamline your workflows.
For example, why not:
- Check immunization history when patients come in to recieve a flu shot. You'll see who is missing the immunizations that are currently due, and you can get your patients up to date while they are already in the office, rather than having to schedule another appointment.
- Streamline your workflows by enabling your staff to work efficiently. Don't slow them down by making them wait to perform procedures that could easily be done when the patient arrives. For example, let the nurse see the patient first for lead and hemoglobin labs. The nurse can enter the results in the EHR before you see your patient, and then when you are in the appointment, you can pull up the results and discuss them with your patient. The alternative is having these tests performed after you see the patient, and then you have to make time to reconnect to discuss results. Sometimes just a slight tweak in the order of events can make your process much more efficient.
4. You're not customizing your protocols. Putting in the time up front to customize your protocols will ultimately save you time in the end by streamlining your appointments. And every minute you save on a protocol is an opportunity to increase your revenue.
Let's say you spend 4 hours one day working on your protocols. And say the tweaks you make will save you 1 minute per visit. With that savings, you'll make those 4 hours back in about 2 weeks. And that savings of 1 minute per patient means room opens in your schedule to see one more patient a day. Even one more appointment per day will significantly build your revenue over time.
Typically, an EHR will come with generic sick and well visit protocols. However, when you create custom configurations of protocols, you tailor them to your specific needs and streamline your visits. These modifications can mean the difference between charting for hours at home every night versus completing your charts during the work day.
Customizing protocols and the ease with which it is done is an absolutely key for me in terms of workflow and efficiency.When I first started with the EHR, I took a bunch of paper forms that I really liked for both well visits and various types of sick and chronic care visits and converted them into a usable form as a protocol. This allowed me to address complicated issues with ease, and helps me make sure I cover everything I am supposed to.
Over time, I have further refined all of these protocols so that the flow through them is exactly the same, reflecting the order in which I like to go through things, and reflecting division of labor between myself and support staff.
Regarding the improved efficiency that customized protocols allow for, he says,
In addition, I have several protocols for very unique situations. I have made and constantly tweak protocols to fit how I think about and approach problems such that I rarely have more than 5-10 minutes of charting to do at the end of the day (primarily just signing off on visits while making sure I didn't miss anything). This can only be accomplished by using protocols that allow for the efficient collection and organization of information.
Overall, the customization of protocols has really helped me use PCC EHR as an efficient tool to augment my medical care, not get in the way of it. Because the customization tools are so easy to use once you learn them, it really makes this into a very flexible product to meet one's needs no matter how you like to approach problems. But that means spending a lot of time learning the elements, defining your workflow, and adopting ways of collecting information that the physician likes in order to make this happen.
Don't forget to reach out to your EHR vendor for help with configuring protocols. Your vendor can help you refine them so that they are personalized to your style. As Jim Smith, one of PCC's Support Team Client Advocates says,
Don't doctor from memory alone. Let the EHR assist you in performing the visit to its full potential.
He shares that many pediatricians will cover topics like car seat usage, adverse childhood experiences, or Bright Futures questions from memory, but that these are topics and questions that can actually be built into a protocol. That will ensure that nothing has to be memorized. The EHR can be utilized to take that burden off the physician's shoulders.
5. You're not leveraging your patient portal. Making full use of your EHR's patient portal will save you tons of effort. The portal can send everything from school forms to doctor's notes to patients. Using it will take the burden away from your staff having to manually complete these kinds of tasks.
6. You're not utilizing your Dashboard. Not all EHR vendors provide a Dashboard. This is a feature to take full advantage of if you have the opportunity. A good practice Dashboard will allow you to monitor and improve your clinical and financial status. When you understand your Dashboard numbers, you understand things like:
- immunization rates
- diagnoses per visit
- well visit rates
Your Dashboard will tell you all that and much more. For example, you can break your well visit rates down into age groups, see which group is falling behind, and then run reports to see which particular patients are overdue for visits.
7. You're underscheduling. Once a patient walks out the door, it becomes harder to connect with them to reschedule, and easier for them to fall away from the routine of annual well visits. Make sure to schedule a patient's next appointment while they are still in your office. Schedule multiple appointments if possible. For example, with newborns there are multiple visits that need to happen in the first 1-2 years. Why not open up your schedule and get all of them on the calendar? It's easy to shift appointments around if a conflict arises. The harder part is getting patients signed up for them in the first place. Take the opportunity to fill your schedule when your patients are still right at the front desk.