By - The evolution of technology not only has an immense impact on society as a whole, but it is also making waves in the medical sector, and more specifically, EHRs.
But with the rapid advancement of technology, prior tools need to update and adapt to keep up with the new advancements.
From a medical standpoint, the maintaining and improving of the EHR is called EHR optimization. It’s common for people to think that once the EHR is implemented, the work is done. But in reality, the maintaining process has just begun.
To improve common clinician burdens, such as EHR usability, interoperability, and documentation, vendors are using this new wave of technology to their advantage by creating tools that aim to aid the clinician’s productivity and efficiency.
Enhancing Interoperability via Artificial Intelligence
EHRs have introduced a host of problems, including disrupting clinician workflows, limiting interoperability, and creating data overload. But with the implementation of advanced technology and the growth of artificial intelligence (AI), EHR vendors are working to improve their products.
READ MORE: How Vendors Are Using EHR Optimization to Combat Coronavirus
Health data interoperability still remains a problem for clinicians, despite the introduction of digital health records. Most technology vendors don’t easily exchange patient information, making it hard for providers to use the EHR to improve patient care.
According to a survey from the Center for Connected Medicine (CCM), nearly one-third of hospitals and health systems reported that interoperability is insufficient, even within their own health organizations.
However, very few of these respondents said that they are utilizing new-age tools such as application programming interfaces (APIs), AI, and blockchain to improve interoperability.
Although a limited number of organizations are currently using AI or advanced technologies, the respondents do believe that these technologies can improve interoperability.
Fifty-two percent of the respondents said that advances in tools will offer some solutions to interoperability issues. Fifty-three percent said that senior leadership commitment to interoperability will address challenges, and 52 percent said financial incentives or penalties are the answer to data sharing problems.
READ MORE: 3 Strategies to Enhance EHR Usability Through EHR Optimization
“Extending advancements in interoperability to the broader healthcare ecosystem will be critical to progressing digital health initiatives and enabling new ways to serve patients,” said Janet King, a senior director of marketing insights at HIMSS Media. “Advancements in technology solutions are recognized by more than half of the healthcare leaders responding to the research as among the most critical elements to make that happen.”
Optimizing the EHR Interface to Boost EHR Usability
Looking at the user interface for the EHR is going to have the biggest impact on optimization.
Interface navigation directly affects how providers use the tool in their everyday practice, having a significant impact on patient safety, clinic operations, and burnout.
A cluttered interface or a complex medication list is the result of an EHR product that is not properly designed or optimized.
In an effort to optimize and clean up the EHR interface, researchers from Beth Israel Deaconess Medical Center implemented a simple visual aid in the EHR to address repetitive or unnecessary test ordering.
READ MORE: 5 EHR Optimization Activities for Improving Clinical Efficiency
Instead of an interruptive alert, researchers set up an EHR visual aid that placed a simple red highlight around the checkbox of the laboratory test order, alerting the clinician to a duplicative or incorrect test order.
Following this implementation, researchers found a 49 percent decrease in unintentional duplicate orders for laboratory tests and a 40 percent decrease in unintentional duplicate orders for radiology tests.
“In our EHR, it takes a minimum of 9 clicks and password entry to cancel an order,” researchers wrote. “Estimating the burden of order cancellation at 9 clicks and 30 seconds, the estimated reduction in unintended duplicate orders saved 17 936 clicks (not including the password) in the year after the intervention, which amounts to 16 hours and 36 minutes of regained productivity.”
“This type of EHR-based reminder may be a useful alternative to interruptive, post-order alerts for reducing duplicate order entry,” continued the researchers. “We believe guiding clinicians to a right action is better than telling the clinician they have made an error. This approach may help reduce alert fatigue and lessen clinician stress and burnout associated with EHRs.”
Although these alerts were set up for laboratory test orders, a similar alert could be implemented into the EHR to remind clinicians of the measurements used for particular drug dosing.
Implementing Virtual Assistants to Aid Documentation
New forms of technology are targeting the way clinicians document their time spent with patients.
Clinicians jump from patient to patient and it’s common for this to cause cognitive burden. Providers face challenges when they have to play catch up on documentation at the end of the day.
“At that point you are relying on your memory,” Mark Grenitz, MD, said in an interview with EHRIntelligence. “You saw 12 or 15 people yesterday afternoon and now you're trying to remember, ‘Was it Mrs. Johnson who said that or was it Mrs. Smith?’ And again, that's not good for doctors. That's not good for patients. It's not good.”
One way to tackle this issue is by implementing a well-designed EHR scribe tool into the EHR workflow.
IKS Health developed an EHR scribe technology called Scribble, which Grenitz described as “scribes on steroids,” to tackle this issue.
Grenitz explained that it records the visit from start to finish, which decreases cognitive burden. Once the patient visit is complete, the medical professional can read and edit the transcript to create a summary of the visit.
The next time the patient returns for a visit, the clinician can quickly pull up the prior progress note to review and retrieve information on the patient.
“It's not the person who's following you around who has to finish this note during the time that I'm with this patient, because we're going to go walk into the next patient's room when we're done,” Grenitz said. “The remote scribes don't have to deal with that pressure. So, their notes are remarkably complete and convey the entire medical gist of the conversation and a very efficient manner, which takes away all that secretarial stuff that are making doctors burn out.”
“You may walk out of the room and in two or three minutes you put in the diagnoses, the orders, and you move on to the next patient,” Grenitz said.
The industry is also leaning on voice-enabled add-ons in the EHR.
Tech giants such as Google, Microsoft, and Amazon are using their technology to get into the medical field, and Amazon, specifically, is attempting to reduce the amount of mouse clicks, the change of computer screens, and ultimately the cognitive workload by introducing this voice-enabled technology.
With AWS diving into the medical field, the company announced the launch of Amazon Transcribe Medical, a speech recognition service that transcribed clinician and patient speech into text. Not only will the tool help physicians document small notes more effectively into the EHR or an app, but it will also transcribe entire conversations into text using correct punctuation.
The implementation of this add-on is designed to limit the amount of extensive note taking, a task that is a commonly linked to burnout and is labeled as a distraction. It also targets cognitive overload by saving the clinician time and mouse clicks.
“Extreme accuracy in clinical documentation is critical to workflows and overall caregiver satisfaction,” said Jacob Geers, solutions strategist at Cerner Corporation, an EHR vendor in using an early version of the tool.
“By leveraging Amazon Transcribe Medical's transcription API, Cerner is in initial development of a digital voice scribe that automatically listens to clinician-patient interactions and unobtrusively captures the dialogue in text form,” continued Geers. “From there, our solution will intelligently translate the concepts for entry into the codified component in the Cerner EHR system.”
Even with the handful of problems that EHRs bring to clinicians, they are not going away. This is why clinician input and EHR optimization are crucial for the future of productivity and efficiency for clinicians.
With the advancement of technology, EHR providers will continue to rollout new tools and add-ons to work with clinicians to limit this burden.
2020-03-24 13:43:00Z
https://ehrintelligence.com/news/top-technology-innovations-supporting-ehr-optimization
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