EHR Systems - Finding the Right Fit

Physicians in small practices need to find an EHR system that is easy to use, affordable, and provides strong overall value. When it comes to finding the right fit, there are certain things to consider.

EHR usability is the key

Why do so many physicians see a drop in productivity when using an EHR system? Why can’t they use an EHR to complete a note during the patient visit the way they could with a paper chart? Some of the factors:

  • EHR systems require doctors to spend more time on documentation
  • Doctors can see fewer patients compared to before they adopted electronic health records

Poor usability and badly designed interfaces are the main culprits. If software is difficult to use and forces users to take extra steps, it must by definition slow them down. The extra time spent typing and clicking takes away from the finite amount of time physicians can spend focused on patients and looking them in the eyes.

If a note cannot be completed by the time the patient leaves the office, additional time is required between patient visits, thus reducing the number of patients that can be seen each day. Alternatively, the physician sees the same number of patients each day, but then stays late in the office trying to recall the details of each visit, finishing notes and missing dinner yet again. Finding a system that allows you to chart faster is key.

How do you define the "usability" of an EHR System?

1. Look at the user interface

The User Interface (UI) is the first element of usability. The UI is literally what a user sees on a screen, from the layout of text boxes and controls like buttons, to the choice of graphics like colors and fonts, to the use of navigational elements like  menus and icons. Each of these components must be optimized individually as well as integrated into a cohesive whole.

The visual presentation of an EHR system has a significant impact on usability. For example, a cluttered screen with too many options can slow down the physician by making the features they want to  access quickly hard to find, while forcing them to whack their way through thickets of less necessary data fields to get to what they do need.

On the other hand, an overly simplistic screen with too few options forces the physician to click back and forth between multiple menus and windows, again slowing them down.

One successful approach to screen layout is to mimic the “look and feel” of a traditional paper medical chart. Not only are physicians comfortable with this familiar approach, it also allows the software designer to strike a balance between cluttered and overly simplified screens.

2. Count the Clicks

Workflow is defined as the sequence of steps or processes required to complete a task from initiation to completion. These tasks can be complex and demanding, such as documenting an assessment and plan during a patient visit, or relatively simple, such as writing an e-RX refill.

Obviously, physicians want to complete a task with as few steps as possible. This often translates into having fewer fields to fill out, fewer boxes to check, and fewer windows to click through.

When comparing EHR systems, you can count the number of steps required to complete a discrete task you do repeatedly throughout the day, such as documenting the History of Present Illness (HPI) or Review of Systems (ROS). The more steps, the longer it will take to complete a note

3. Use Templates

When used appropriately, macros and templates can be valuable in improving the completeness and efficiency of documentation, particularly where that documentation is primarily limited to standardized terminology, such as the ROS and physical examination findings. Overuse of templates, however, can result in cookie-cutter notes that all look and sound the same. Additionally, templates don’t always support good documentation. This is especially true for more complex patients whose stories don’t fit within the confines of standard templates.

Look for an EHR system that includes the ability to create customizable templates that support your practice’s specific needs, and avoid EHR systems that minimize free text entry.

How to Find a Usable EHR System

1. Look at User Surveys

When it comes to judging EHR usability, who can you believe? Will you believe software vendors? Or peers who have real-world experience using different EHR systems every day?

2. Test the EHR System in your Office

Once you’ve identified a few EHR systems for further evaluation, you need to get a free trial of the software to use in your office. Only by using a full version of the software – not a “demo” version – in your practice, seeing real patients, will you know if an EHR system meets the criteria for usability as documented in this white paper.
 
Ask potential EHR vendors if you can have a free trial for a few weeks. If they say “no,” you should ask, “why not?”
 
3. Overcome the Fear of Switching
 
Switching isn’t as difficult as you probably think. There are migration tools that can help you move patient data from one EHR system to another. Many EHR system vendors will provide these free switching tools and other services as an incentive.

Amazing Charts EHR - Designed for Small Practices

Amazing Charts EHR was designed by an independent physician who needed an EHR system that was easy to use and that he could afford. Join other small practices who have already made the switch!