| | December 20178CIOReviewIn my opinionEHR OPTIMIZATION-MAKING THE EHR WORK FOR PHYSICIANS By Luis Saldana, CMIO, Texas Health ResourcesBackgroundHealthcare remains a hot topic in the media and in daily conversations. Within those conversations are threads about the crisis of physician burnout. This trend emerges within a period of rapid change in healthcare, which has seen the advent and rapid adoption of Electronic Health Records (EHRs). Much of this rapid growth in EHR adoption has been driven by government mandates and programs such as meaningful use, rather than being physician driven, which has fostered a real sense of a loss of control.This regulatory-driven growth has driven an explosion of documentation and reporting requirements and thrusts burdens onto physicians and nurses via the vehicle of the EHR. It can consume precious time, sometimes at the expense of time best used with their patients and their families.There is a great quote that says "technology makes a good servant but a poor master," and I think this is very relevant to physicians' relationships with EHRs. So how can we shape the EHR to reclaim the right relationship with physicians and reduce their burden? Many of the barriers reside within EHR optimization.Much of the burden probably falls on EHR vendors who have had the same pressures in development, driven by regulatory requirements. These programs have been a boon to EHR vendors, while also handcuffing them in terms of development prioritization. This has also led to consolidation in the industry, with the disappearance of many niche specialty-focused vendors. This unfortunate consolidation appears to benefit "big" vendors, who work to fill these needs with specialty "modules." They spend more time supporting existing functionalities to work within these frameworks rather than developing novel functionalities to solve physicians' real challenges. They also spend much of their development efforts on functionalities rather than on workflows, and most of healthcare is delivered via workflows.But will these regulatory burdens diminish or disappear? Unlikely, but we have heard some rumbles on this from CMS. According to a recent CMS article on quality payment programs to reduce physician burdens, CMS has "heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient." CMS administrator Seema Verma, adds, "That's why we're taking a hard look at reducing burdens." So, how can we find a way forward to benefit clinicians in the context of these burdens, and ultimately benefit patients?There is much dialogue around improving the usability of EHR systems, which largely focuses on data presentation, user interfaces and technical design. Much of the burden here falls once again to the EHR vendors, who are starting to put more attention on usability, but there is still a long way to go to approach the usability of consumer applications. In addition, there is a
< Page 7 | Page 9 >