Most Common EHR Workflow Inefficiencies

It’s well known that physicians and other healthcare professionals have felt frustrated by the amount of time they’ve spent navigating electronic health record (EHR) workflows, as well as the concerns healthcare organizations have for this time usage. In 2020, a study by the Annals of Internal Medicine quantified this time. With 155,000 nonsurgical/ambulatory practice physicians in the United States participating, the study focused on thirteen clinical functions and 100 million patient encounters with time averages per physician specialty computed.

Results indicated that physicians spent:

• An average of 16 minutes and 14 seconds per EHR encounter
• 33 percent of their EHR time on chart review
• 24 percent of their EHR time on documentation
• 17 percent of their EHR time on ordering
• Widely varying amounts of time on EHR usage based on their specialty

Here’s the conclusion of the study: “The time spent using EHRs to support care delivery constitutes a large portion of the physicians’ day, and wide variation suggests opportunities to optimize systems and processes.”

HealthTECH Resources recently reported on a related phenomenon: how EHR system inefficiencies can lead to clinician burnout; the most significant responses include those from 26 percent of hospital healthcare workers who report anger and 29 percent of them who are considering leaving the medical field.

Plus, at the Mann-Grandstaff VA Medical Center, veterans are waiting too long to receive care and, when they do, safety concerns are worrisome. Resignations of key personnel (who are frustrated with the EHR system) are compounding the problem. In a September 2022 survey, Mann-Grandstaff’s disheartening statistics include:

• 71.7 percent of employees say morale has worsened because of EHR problems; more specifically, because of:
  • Less efficient work processes: 92.5 percent
  • Increased documentation time: 82 percent
  • Minimal improvement in the EHR system: 81.4 percent
  • Patient safety concerns: 76.7 percent
  • Increased burnout: 71.5 percent

These statistics clearly indicate that better workflows must be designed to save clinician time and streamline their EHR experiences to reduce their levels of frustration and the resulting burnout. Here are some of the more common workflow issues to address during EHR implementation.

Interface and Field Entry Locations

When an EHR interface is difficult to see or confusing to navigate, its usage will take longer than it should and create unnecessary frustration. The same is true if screens take too many clicks to find.

So, when you’re upgrading your current application or installing a new EHR implementation, it’s vital to pay attention to where data fields will be located compared to where they used to be. In the new setup, is it likely that end users will enter incorrect information in a field because it’s placed where a different one was? What if that field was one used to enter, say, prescription information? What impact could that have on patient safety?

Lack of Training

Even when an EHR implementation is optimally completed, if the end users aren’t educated in its most streamlined uses, then time will be wasted and frustrations will ensue. Physicians will have less time to spend with patients, which goes against the healthcare organization’s main goal—outstanding patient care—and interferes with the clinician-patient relationship.

A far better approach: EHR consultants capture process documentation to create written materials used in initial training programs, refreshers, and reference material at workstations. Before an EHR system goes live, end users would be comfortable and proficient with the staged application—and have all the materials and support they need with a live system.

Incorrect Workflow Access

When permissions to see certain data don’t align, then miscommunications—including potentially serious ones—can occur. If a physician adds a note to a patient’s record, for example, but other professionals can’t see the note, then serious mistakes can take place.

One of the key benefits of properly optimized EHR systems is care coordination, which eliminates duplicate testing and treatments that aren’t necessary. For this to smoothly occur, it’s vital to ensure that appropriate workflow access is given to each end user, which is based on their job roles and their need to know certain information.

Poor EHR Data Migration

An often-quoted statistic from Gartner states that 83 percent of data migrations either fail or exceed their timetables and budgets. Whether this figure is still accurate or not is uncertain, but what is true is that an electronic health record implementation is only as good as the quality of the EHR data migration.

Mapping errors can have significant, negative implications for both healthcare providers and their patients. To avoid this, plenty of planning must occur and, with quality migration, avoid any assumptions that data will naturally flow from one application to the next.

Strategies for successful EHR data migration (and other EHR implementation components) include “bringing the right people to the table to map out a workable plan of action” internally and leveraging external organizations as needed.

Building a Healthy Healthcare IT Team

To address inefficiencies and optimize your use of technology, it’s important to build a healthy healthcare IT team. Some crucial steps include to:

1. Have solid plans in place: This is true when you first start a project and will continue throughout its implementation and beyond.
2. Balance in-house headcount with specialized outsourcing: Knowing how to maintain internal resources and when to reach out for additional EHR consulting talent is vital.
3. Consistently iterate as situations evolve: In other words, be willing to course-correct as needed, focusing on your goals and agilely pivoting as relevant.
4. Communicate, communicate, communicate: Encourage and enhance quality communications among in-house team members, employees who work remotely, and EHR consulting professionals.

HealthTECH Resources for Your EHR Consulting

If you’re looking for specialized talent to execute EHR implementations and optimizations that address workflow inefficiencies, contact us today. We’ll help you determine staffing gaps and how to fill them, which will allow you to maximize your application usage while creating a healthy environment for clinicians where your organization can truly provide world-class health care. To discuss your specific needs and get questions answered, please contact us online or call (602) 903-7961.