5 Tips for Improving Provider Productivity with an EMR

The most recent EMR adoption numbers I’ve seen are putting EMR adoption at about 60% of doctors. When I think about the other 40% of doctors that have yet to adopt an EMR, my guess is that the biggest reason they haven’t adopted an EMR is based on their fear that an EMR will negatively impact their practice and their productivity. They fear that a change to EMR is going to be negative rather than a positive that it could be.

A whitepaper called Getting Lean with Your Practice: Five Tips for Improving Provider Productivity with an EHR does a good job looking at the issues of productivity in a practice and how to improve that productivity. One thing it points out is that if you can’t measure it, then you don’t really know how you’re doing. Turns out, an EMR is a great way to measure productivity.

Think about all the data an EMR can produce that would have never been possible in an EMR. Patient wait times and documentation times are the most obvious when we’re talking about productivity. In the paper world, you really didn’t have a good idea if a doctor had 20 charts outstanding or none other than looking at the stack of charts on the desk and checking them. In the EMR world, you can easily report on who’s staying up with their charting and who is not.

In the productivity whitepaper mentioned above, after studying 25 providers at 12 diverse practices they found that same-day encounter close rates (ie. finishing the charting the day of the visit) was the single most revealing metric about the success of patient workflow processes. They suggest that this doesn’t mean you document every patient as you seem them. Instead, they suggest documenting as much as you can with the patient when you’re with them and then you wrap up any complex patients as the end of the day. This is usually the right balance for most doctors I’ve worked with as well.

Here are the full 5 tips from the whitepaper:

  1. Start on time.
  2. Work with cross-trained staff that can handle intake and documentation.
  3. Document encounters as much as possible during and immediately after visits, but don’t document more than necessary or spend too much clinical time on complex documentation.
  4. Close all patient encounters by the end of the day – This should involve just wrapping up documentation for complex encounters.
  5. Route documents appropriately and delegate responsibility for document handling effectively.

One of the other great takeaways from the whitepaper is the idea that doctors can and should be delegating more of the documentation to their staff. A Dr. Lizabeth Riley pointed out that “the data the system provided immediately opened my eyes to the fact that I was only giving my staff 1% of charting duties! Once I saw that, I knew thing had to change. My staff now does 40%-60% of my charting for me.”

There was a lot more interesting data in the whitepaper including the 5 different physician work styles from Truly Lean to Falling Behind and Frustrated. This last group is behind the EMR backlash. Hopefully some of the tips above can help a doctor become more productive with their EMR.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

7 Comments

  • This is a great whitepaper. Thanks for sharing it. Productivity is such an enormous problem in the current state of EMR. Although, I don’t think it’s a software issue as much as it is a workflow issue. Once you work out the right workflow, the doctor is able to solve the productivity issue.

  • Thanks Stevie. I agree that almost all of the EMR productivity issues can be solved by an adjustment to the workflow of an office. Although, some EMR vendors make that adjustment easier than others.

  • John, this white paper confirms (once again) the importance of “systems” thinking when implementing an EHR. This should be old news, but obviously the problem persists. What do you think are the major reasons that workflow/systems thinking is not a routine part of every implementation?

  • J Carter,
    It sounds like you’re asking why common sense doesn’t prevail in every EHR implementation. I’m not sure I have an answer. Selfishly I’d like to say it’s because not enough doctors are reading my blogs;-)

  • Actually, I was wondering what you see as the root of the problem. National surveys indicate that not all practices benefit equally from having an EHR. Workflow issues are often the culprit. Why? Are vendors failing to offer sufficient help with workflow redesign? Are practices refusing to take the time to do proper workflow adjustments? Is there still insufficient awareness of the need for workflow redesign with implementation?

    Do you see a slant toward any of these three possible reasons? Just curious to hear your thoughts…

  • I think the first two reasons are the core of the problem. They’re very much related. The fact that many clinics don’t want to do workflow adjustments means that it’s not good for your EHR business to try and convince them that when implementing an EHR you need to adjust the workflow. If an EHR vendor starts telling them about all the workflow they’re going to have to adjust, then they’re not likely going to make the sale.

    There are a few exceptions to this. I know some EHR vendors that lead with the idea of having to adjust your workflow. They only want to work with clinics that understand this need to change. Long term these EHR vendors will have created a good name for themselves.

  • […] A whitepaper called Getting Lean with Your Practice: Five Tips for Improving Provider Productivity with an EHR does a good job looking at the issues of productivity in a practice and how to improve that productivity. One thing it points out is that if you can’t measure it, then you don’t really know how you’re doing. Turns out, an EMR is a great way to measure productivity. Read More […]

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