Involve Doctors, Caregivers to Improve EHRs: Physician Survey

Health systems could be doing more to help physicians and other members of the care team derive optimal benefit from their electronic health records (EHRs) and other health information technologies, a new survey reports. Among the most important steps organizations can take to make more of their HIT investments are proactively soliciting input from physicians and involving all clinical users to ensure adherence to HIT-related processes and workflows, the Deloitte 2018 Survey of Physicians reveals.

Despite their leading role in the delivery of medical services, physicians often perceive themselves as passive participants in EHR optimization efforts and feel frustrated with their existing systems' lack of interoperability as well as the documentation burden those systems impose on them, the survey found. (These obstructions have been well documented in numerous studies of the causes of physician burnout, which remains at epidemic levels in the United States.)

The consulting firm surveyed 624 primary care and specialty physicians in the U.S. that matched the American Medical Association Masterfile with respect to years in practice, gender, geography, practice type and specialty to reflect the distribution of U.S. physicians.

"At this point, many health systems are trying to optimize and realize the benefits of this expensive investment, but there is still a long way to go," the survey report notes.

When asked what changes they would make to their current EHR to deliver better care, 62 percent of physicians cited increased interoperability and 58 percent said they would improve the system's ability to allow them to easily add new information. Although "achieving interoperability can seem like a mammoth task," the report suggests that, "at a minimum health systems and EHR vendors can share updates with their EHR users about important interoperability milestones achieved or functionalities added. Any improvement could support physicians in delivering care more efficiently."

The number-one area where physicians see opportunities for improved efficiency is documentation. Thirty-six percent of physicians said documentation-related tasks impose the greatest inefficiencies on their everyday workflow. "I input a lot of patient data from a form the patient completes on paper," said one participant, a pediatrician. "If the patient could complete this on a tablet or device and it was automatically synced to my note, it would be a huge time-saver."

The report recommends that health systems tap their EHR usage analytics, if available, to understand more about causes of documentation burden for physicians and pinpoint ways to address those causes. For example, analytics that reveal long documentation time per appointment after work hours may indicate inefficient use of note templates or poorly designed templates.

Only 34 percent of physicians indicated that their organizations solicited their feedback in making EHR improvements. However, organizations benefit when that participation takes place. Soliciting feedback and engagement go hand in hand, the data indicate. Fifty-one percent of physicians who were not asked for feedback said they are unaware of their organizations' optimization efforts, while only 16 percent of physicians who had been invited to provide feedback said the same.

The report recommends seeking physician involvement through town halls and surveys; cultivating "super users," champions with influence who can bolster engagement among the medical staff; and a dual approach that combines direct physician input with EHR usage analytics. A two-pronged effort involving physician feedback and analytics can "paint a more nuanced picture of how physicians use EHRs, what can be done to improve their experience and what's the impact of interventions."

The complete survey report is available here.

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Monday, 18 February 2019

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