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Jun 21 2011   10:53AM GMT

Physician adoption and engagement of EHRs: Part science, part art



Posted by: Jenny Laurello
EHR, EHR Adoption, electronic health records, EMR

Guest post by: Wendy Whittington, MD, MMM, Chief Medical Officer, Anthelio Healthcare Solutions, Inc.

Medicine is often said to be part science and part art.  The process of implementing a hospital electronic health record (EHR) system also needs to be part science and part art in order to engage physicians in the adoption of the system.

SCIENCE

This part is based on involving physicians in testing and tweaking the system.  They need to have multiple means and multiple opportunities to be involved in testing the system. Additionally, the implementation team must be honest about reporting out the results of the testing.   If the tests and results are dealt with scientifically and honestly, the system will be improved and clinicians will appreciate the sincerity of the efforts on their behalf.

Using a checklist of the 25 most common user actions is one way to test the system.  Observers can scientifically record the actions of physicians as they try to find the concepts they are looking for (diagnoses, orders, medications) and the results of those actions.  This is not to test the physicians, but the system.  Does the system allow the physicians to do what they need to or does it force suboptimal performance?  One example of this is menus that force H&Ps to be filed as “consultations” when no one would look there for them.  Another is the buttons that mysteriously closes past medical history inadvertently. If problems such as these exist, the physicians will find them. 

ART

This part is equally as important as the science.  This is the relationship aspect of the process.  It means understanding that time is money for busy clinicians and that they are not any more excited about change than the rest of us.  Pace is crucial.  Are we implementing the system at a pace that gives the appropriate care and importance to what is being implemented?  Are we paying attention to the emotional impact of the new system?  Will frustration take over if it takes more than a few months to address needed changes?

If physicians are now doing work normally done by others, do they have a clear understanding of the benefits to their patients, if not themselves?  Can we clearly demonstrate how our system contributes to patient safety, or are we assuming that it’s obvious?

Setting reasonable expectations about what is to come from implementing a new EHR system means realistic goals, efficient, well-thought out processes and documented outcomes, addressing both the art and the science.  Does your EHR project have all these?

For more on this topic and more, please visit Anthelio’s blog at www.healthyinnovation.net

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