Family physicians spend 51 hours in practice each week, with 24 percent of that time spent interacting with the electronic health record (EHR), according to the 2018 AAFP Practice Profile survey. In the average week, family physicians spend 7.3 hours on the EHR during clinic hours and 5 hours on the EHR after clinic hours.
Lobbying EHR vendors to create better, interoperable products is critically important, but these efforts can take years. In the meantime, what can physicians do to make their EHR work less frustrating?
1. Try team documentation.
Team documentation allows physicians to delegate certain documentation tasks to a well-trained nurse or medical assistant. Medicare recently simplified the documentation guidelines to allow for team documentation. For both new and established patients, physicians no longer must re-enter information in the medical record regarding the chief complaint and history (including the history of present illness) that either ancillary staff or the patient have already entered.
2. Involve the patient with the EHR.
Instead of focusing on the computer in the exam room to the exclusion of the patient, involve the patient in what you’re doing, advises Atul Gawande, MD. Say, “Let’s go through these checks together.” Angle the screen toward the patient, and side by side confirm that the medical history is up-to-date, that you’ve reviewed any medication allergies, etc.
3. Don’t start from scratch.
Save your most frequently used notes or orders to a favorites folder in your EHR. If a new encounter does not fit exactly with what you have saved, you can simply adjust the details, which is usually more efficient than creating a new note or order from scratch.
4. Get help from your colleagues.
If you’re struggling with certain aspects of your EHR, don’t keep fighting the same battle over and over. Find “power users” and learn from them. If you can’t find one physician who has the answers you need, invite doctors from your group or elsewhere in the community to join you for a discussion about ways to use your EHR system more effectively.
5. Keep the patient in mind.
Remind yourself that certain tasks such as communicating lab results electronically, answering messages via the computer, and completing patient forms are necessary parts of patient care. Consider having staff put small photos of patients in their electronic charts to serve as reminders that you are connecting with your patients. You are not just doing computer work.
Read the full FPM articles: “Lessons From the Road to EHR Usability,” “Get Help With Your EHR – Over Coffee,” and “Reducing Frustration and Increasing Fulfillment: Reframing.”
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