Software

Getting the Most out of Your Electronic Health Record

Optimization of electronic health record systems should focus on simplification, interoperability and data security.

Jamie Lynn Ray is a healthcare strategist at CDW with over 20 years of experience leading multimillion-dollar clinical and financial application services, infrastructure, information security and operational engagements.

Mike Larsen

Mike Larsen is an accomplished information technology leader with over 19 years in the healthcare industry spanning inpatient and outpatient service lines. He has extensive project and program management experience, including the implementation of Epic electronic health records and the development of enterprise analytics and architecture functions.

Over the past decade, healthcare organizations have refined their electronic health record workflows, but challenges remain in the areas of data entry, availability, visual display and workflow support, according to the American Medical Association. Unfortunately, providers bear the brunt of these limitations, resulting in a bigger administrative burden and less time spent with patients. This struggle coincides with a period of increasing clinician burnout in the wake of the pandemic.

Those organizations that take an intentional approach to EHR optimization will make themselves stand out. The most successful optimization initiatives balance usability and security without compromising patient safety. Simplifying workflows not only ensures repeatable and predictable outcomes but also removes waste and toil from the healthcare delivery system. Once systems have been standardized, IT teams can begin to pursue integration by enabling technologies including voice recognition and artificial intelligence (AI). This tried-and-true approach has proved effective for organizations that pursue this worthwhile exercise. Finally, and most important, organizations should prioritize data security at all steps of the optimization journey.

Healthcare organizations often fall into two distinct groups: early adopters and the late majority. The early adopters have been on established EHR platforms for a decade or more. The late majority are organizations that have transitioned to a new or replacement EHR in the past five years. There are inherent optimization challenges for both groups. For example, early adopters have had ample opportunity to build workarounds and custom workflows. Workarounds add unnecessary complexity and can create maintenance and support headaches. Organizations in the late majority are dealing with another problem entirely. Using out-of-the-box functionality allows healthcare organizations to quickly go live. But this speed to delivery comes at an expense: Workflows may be effective, but they are not necessarily efficient.

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How Health IT Teams Can Optimize EHR Workflows

In terms of optimization approaches, application rationalization, clinical workflow analysis and patient journey mapping help to simplify the operating environment and establish a baseline for the end-user experience.

App rationalization is a strategic process focused on eliminating or replacing inefficient and outdated tools and consolidating redundancies. Effective application rationalization requires executive sponsorship (clinical and operational) and a comprehensive understanding of use cases, platforms and capabilities. Although the focus of app rationalization is the EHR and patient care platforms, it is important to evaluate the entire ecosystem of supporting information systems. Following application rationalization, the real work begins in the form of clinical workflow analysis and patient journey mapping.

Clinical workflow evaluation is all about streamlining administrative and clinical process. To that end, healthcare organizations have taken a page from the manufacturing sector in terms of process and methodology. For example, Lean Six Sigma management principles have been introduced in hundreds of healthcare organizations in an effort to instill rigor and discipline within these exercises. When selecting workflow improvement candidates, the Pareto rule (that 80 percent of consequences come from 20 percent of causes) applies. Put simply, healthcare organizations should avoid trying to boil the ocean and instead focus on the top workflows that will drive maximum value and ROI. Patient journey mapping is another helpful exercise, and it helps to keep the patient at the center of all optimization exercises. Patient journey mapping is exactly what it sounds like: a documentation of all patient touchpoints (and pain points) within the healthcare organization.

Once the foundation has been established in terms of rationalization and clinical process improvement, healthcare organizations can begin to layer emerging technologies through platform integration. Through the course of the pandemic, we saw firsthand the power and reach of virtual care platforms, and the benefits of emerging technologies cannot be overstated. Progressive healthcare organizations are already experimenting with next-generation Internet of Things devices for telemetry and remote patient monitoring. Connectivity with wireless sensors and the implementation of clinical decision support tools hold the promise of a safer future. Voice recognition and AI are poised to deliver even greater benefits, from ambient dictation to clinical documentation generation. All of these enhancements will decrease data entry and medical errors while enhancing the human connection between patient and caregiver.

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Best Practices for Approaching EHR Optimization and Interoperability

The major takeaway is that EHR optimization requires a multidisciplinary team dedicated to continuous process improvement. In addition to IT, clinical, operations and quality control stakeholders should constantly assess how the system is functioning and where improvements can be made. This can be accomplished through app rationalization or the addition of new tools to make engagement with the EHR an easier experience.

Education and training should also be a major component of optimization and integration initiatives. For example, updated EHR workflows should be socialized with clinical end users long before they go live. Similarly, new integrations can be a force multiplier for clinicians, but only if they know how to properly leverage the technology. Policy and governance structures must be in place prior to the introduction of these new technologies, particularly AI, in order to define security requirements and parameters for use. And don’t forget the patients. Patient education should always be included in the training strategy.

Finally, organizations should never forget the importance of cybersecurity. Not only is protecting patient information a requirement, but preventing and minimizing the impact of a cyberattack can save organizations money from having to pay a ransom or from costs incurred due to downtime. Most important, having a strong security posture and cyber resilience strategy in place better supports patient care. Security teams should be included in the EHR optimization process to identify vulnerabilities related to access and encryption.

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How Technology Partners Can Support EHR Optimization

Partners such as CDW have experts on hand with decades of EHR experience who can help healthcare organizations conduct high-level assessments of their systems, do gap analysis and create roadmaps. CDW can also guide organizations looking to migrate EHR workflows to the cloud or offer support to healthcare security teams that are understaffed or lack the skill sets needed to protect patient data against today’s threats.

As healthcare organizations approach interoperability with the EHR, whether focusing on natural language processing or other AI- and machine learning-based tools, it’s important to collaborate with vendors and partners.

This article is part of HealthTech’s MonITor blog series.