Lessons From the Road to EHR Usability


You may be able to get more out of your electronic health record by discovering the system's hidden tools.

Fam Pract Manag. 2017 May-June;24(3):21-24.

Author disclosure: Dr. Fadden disclosed that he is employed by Cerner Corp., which develops health information technology products and services, including electronic health record systems.

Many physicians confront the same problem when it comes to successfully incorporating electronic health record systems (EHRs) into their practices: They do not know the full capabilities of their systems and therefore miss many opportunities to make their EHRs more efficient and easier to use.

As my focus on medical informatics has grown from a small part of my clinical and leadership responsibilities to a full-time role involving daily interactions with EHR users, I have refined my approach to helping physicians adopt and use their EHRs more effectively. Several key strategies have increased productivity and satisfaction among the physicians I've coached. In this article, I will share this practical framework to help you get the most out of your EHR.

The setup

Physicians are often frustrated that their EHR systems are neither simple nor intuitive, and they perceive that this has reduced their efficiency.1 For example, when reviewing a practice's EHR setup, I have seen physicians count the number of clicks required to do certain tasks.

A successful approach to making navigation easier begins with observing how much information is presented on each screen. Denser displays of information tend to require fewer clicks or scrolling to review that information, and vice-versa. It is important to focus on displaying the data that is most valuable to you. Ideally, most if not all of it is clearly visible on the initial screen. If certain data is rarely used and you do not need it readily displayed, ask your software vendor or the physician or other person responsible for your organization's EHR implementation to remove it from the layout. Be assured that the information is still in the record, albeit a few clicks away.

Using larger monitors with sharper resolution can also make a big difference. Many software systems are designed to display information vertically instead of horizontally, so using monitors that can accommodate a vertical or “portrait” mode can also prove effective. Many cost less than $200, which can be a good investment in physician satisfaction.

When struggling with the larger technical challenges of some EHRs, simpler changes such as these can be overlooked. Once you have created the best possible setup, it is time to improve efficiency across four fundamental workflows for providing good care: reviewing information, selecting the diagnosis, enacting the plan of care, and documenting the care.

Reviewing information

Finding the relevant information for a patient encounter can often require a substantial number of

About the Author

Dr. Fadden is a consultant and hospitalist at Eastern Shore Hospital Center in Cambridge, Md., as well as director and chief medical officer for Community Works, a division of Cerner Corp.

Author disclosure: Dr. Fadden disclosed that he is employed by Cerner Corp., which develops health information technology products and services, including electronic health record systems.



show all references

1. Friedberg MW, Chen PG, Van Busum KR, et al. Factors affecting physician professional satisfaction and their implication for patient care, health systems, and health policy. Rand Health Q. 2014;3(4):1....

2. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573–576.

3. Kuhn T, Basch P, Barr M, Yackel T. Clinical documentation in the 21st century: executive summary of a policy position paper from the American College of Physicians. Ann Intern Med. 2015;162(4):301–303.

4. Hirschtick RE. A piece of my mind. John Lennon's elbow. JAMA. 2012;308(5):463–464.


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