2022 Clinical Workflow Flexibility Challenges in the EHR: Defining the Problem (Part One)

Defining the Problem: Flexible Workflows in the Electronic Health Record (EHR)

The Electronic Health Record Association (EHRA) Clinician Experience Workgroup met with the HIMSS Physician Committee shortly after HIMSS 2021 to discuss areas of shared focus and create plans for collaboration over the next year. Our groups already agree on the quality, safety and efficiency-of-care benefits, to both providers and patients, that EHRs have brought. We also agree that there is more work to be done to improve and deepen the impact of these tools on care delivery, documentation and clinician satisfaction. The focus of our meeting was to decide where action was most urgently needed to raise the bar for EHRs. One topic that was of interest was the sense that EHRs lacked flexibility within clinical workflows. This series will provide a summary of our discussion, the areas of focus we agreed upon, as well as some of the promising solutions we discussed.

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Enhanced EHR Usability Starts With Understanding Users’ Needs and Challenges

By the EHRA Clinician Experience Workgroup

EHR utilization places a number of burdens on clinicians that can impact decision-making, workflow and satisfaction. This has been confirmed by recent studies, including one published earlier this year by the Journal of Biomedical Informatics which found that clinicians face numerous cognitive demands when using EHRs. The study concluded that the management of those demands ultimately limits clinicians’ agency to work individually and collaboratively while failing to help them develop awareness of, or reason about, the big picture or their patients’ current and future states, including effects of potential treatments. 

A study in Journal of the American Medical Informatics Association (JAMIA) found that when goal-based decision-making, sense-making, and agency/autonomy are overlooked in EHR design, it results in increased cognitive load, emotional distress, and unfulfilling workplace environments. And a study from Mayo Clinic and the American Medical Association (AMA) and published in Mayo Clinical Proceedings, gave EHR usability a grade of F, which is “markedly lower” than for most other technologies. Researchers further noted a strong relationship between usability and risk for physician burnout.  

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State of the Note Summit 2021 from ACP and EHRA

By EHRA Clinician Experience Workgroup

In January of this year, CMS adopted new billing guidelines from the American Medical Association (AMA) regarding E&M coding. The new guidelines include a wide variety of much-needed changes focused on streamlining billing processes and reducing clinical documentation burdens.

Seeing this as a watershed moment for clinical documentation and an opportunity to produce shorter, more clinically focused notes, the American College of Physicians (ACP) partnered with the Electronic Health Record (EHR) Association. Together, we examined the practical impacts of the coding changes with our community of vendors and clinical stakeholders, specifically:

  1. What consensus about documentation burden exists across vendors, healthcare organizations, and specialist societies when interpreting the guidelines?
  2. What questions, if any, exist around the guidelines?
  3. How can we effectively educate the community about the impact of the guidelines?
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Five Ways EHRs Are Helping CDC Track COVID-19 Vaccinations

By the EHR Association COVID-19 Task Force

In December, two COVID-19 vaccines received authorization from the FDA, and the federal government began distribution to the states almost immediately. Millions of Americans have already received their first dose – many their second – and millions more will be vaccinated in the coming weeks and months. While social distancing, frequent hand washing, and face masks remain vital tools in limiting spread of coronavirus, we can increasingly see our way to a full return to hugs and handshakes, in-person meetings, travel, pubs and parties, concerts and classrooms.

As we anxiously await a return to our old way of life, public health experts, policymakers, and the public are watching the CDC vaccine data tracker, updated every evening with the latest numbers, including: 

  • How many vaccine doses have been distributed to-date? 
  • How many vaccines have been administered?
  • How many people have received their first dose? 
  • How many people have gotten a second dose?
  • Which vaccine is being administered?

But how does the CDC get all that data? The answer varies, but it’s made possible by technology, and electronic health records (EHRs) have been a key player from the beginning. 

Here are five ways that EHRs and the EHR Association are playing important roles in vaccine administration and data collection in the United States.

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Coronavirus: How EHRs Are Supporting Clinicians

For updated COVID-19 resources for health IT developers and other stakeholders, click here.

Coronavirus-badge-300As cases of COVID-19 caused by the novel coronavirus continue to be identified in more and more locations, clinicians are understandably concerned with the challenge of diagnosing potential cases among their patients presenting with flu-like symptoms. EHR developers have prepared for crises like this, and resources embedded in EHRs can help. (more…)

Usability Begins With The User

By the EHR Association’s Clinician Experience Workgroup

world usability day logoToday is World Usability Day. On November 14, events around the globe celebrate how developers can make our world easier for all with technology that works to harness human potential. This year’s World Usability Day theme, “Design for the Future We Want,” is inspired by the United Nation’s (UN’s) 17 Sustainable Development Goals—number three on the list is health and wellness. 

EHRA has scheduled its next Usability Summit for January 29, 2020 in Washington DC

Incorporating user-centered design into health IT contributes to better patient care by considering individual users’ preferred style, vocabulary, information visualization, and workflow in software development decisions. The goal is for EHRs to not only be usable, but helpful, such as by integrating clinical decision support, PDMPs, e-Prescribing, and other technology into clinicians’ workflows. (more…)

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    Kasey Nicholoff
    staff @ ehra.org

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    Communications and Media
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