Practical Master Tips From a Tech-Savvy EHR User
Tech-Savvy Users
In my mind, there is a significant difference between knowing tips and tricks to make your life easier in the clinic and being innately curious to explore and navigate technology. Over the years, my tech-savvy mentors and friends tended to dig deeper and explore the EHR. They came up with exciting tips and handed them to end-users on a plate of gold. I want to emphasize that you don’t need to be tech-savvy, but you do need to know where to go. Be open to modifying your workflow by including and trying these tips.
We all have different talents and skill sets, and you don’t need to be tech-savvy to be efficient. However, it’s a good idea to learn from tech-savvy friends and colleagues. The IT staff can provide some fundamental insights and an introduction to how to use the EHR, but to get practical workflow tips, it’s best to learn from an efficient practicing clinician. If you’re looking to improve your clinical efficiency and EHR utilization, I would recommend identifying the most efficient clinician in your area and asking them for a presentation or a series of them. You can also shadow them during a half-day clinical to gain practical mentorship. The workflow lessons you learn can be precious in your daily practice.
Status Quo Bias
Humans are not big fans of change, and we tend to develop a routine and stick with it. It gives comfort to the brain and limbic system. You know the famous quote: ‘Why rock the boat?’ That’s why many people write about managing change and dealing with resistance, which is a daily struggle in leadership. Your routine will determine how efficient you are. To combat stagnation, inertia, and the preference to stay where you are, I suggest consciously going through the pains of change. It can help you improve your routine and eventually have a steady state that is more efficient.
Explore
I encourage you to take the lead and start discovering your EHR system. From a programmer’s standpoint, they want to make the system user-friendly, easy to navigate, and comprehensive to cover your needs. As you start exploring different menus and buttons, you’ll likely be impressed with the new things you discover and how simple things can save you a lot of time. Don’t underestimate the time you can save per patient when multiplied by the number of patients you see per week, month, and year.
In Cerner (my current EHR), when I was playing around under the options menu while in the documents, I discovered that you could default the collapsing of certain note types. I specified the outpatient endocrine notes, phone notes, and discharge summaries. This made my life far more manageable when I wanted to see who last saw the patient when it was, and if the patient got admitted to the hospital.
As part of workflow management, I frequently look at the details of the scheduled visits, who scheduled them, and when they happened. The beauty of the EHR is that everything gets logged. This is under (Action history), but for whatever reason, it’s the 15th in the order of the tabs. You need to click 15 times on the ‘right’ button to get there. When I went there, I kept looking for its options and eventually got it to be the first tab. When I shared this with my nurse lead, she was so grateful and regretted her time spent doing the 15 clicks with every patient in the last seven years. This was a core part of her daily routine with every patient.
When you start exploring various options, you’ll begin to have questions and concerns, and this is when you should start using the informatics people who are trying to help you in your clinic. Computer systems are always on the move, so try to participate in this movement. Your concerns will be considered if legitimate, and your life may get a bit easier. After the introduction of the ability to upload images to our notes, it was a significant improvement. After a while, the ‘Browse’ option was not working, and I couldn’t upload the image files for my ultrasound pictures. I submitted a Helpdesk ticket, and they found that the plug-in had a code error. They promised to fix it with the next upgrade, and they did. It was great, but I doubt it would have been corrected if it wasn’t pointed out.
Insulin pumps and continuous glucose monitors (CGMs) are the bread and butter of an endocrinology practice. That’s what we do for many patients daily in the clinic. During my training as a fellow, I got exposure to a single type of insulin pump, and the nursing staff were the ones pulling the report. I had no clue how to do it. Everything was coming my way when I started practicing after fellowship, and I had to learn them. However, many staff members needed to improve with technology, and the clinic workflow was challenging for me and my more experienced peers. You have one of two options: continue the frustrating situation and keep complaining, or work on finding a solution. I asked the clinic manager and got access to all the online accounts for all these devices. I spent significant time understanding how to upload and link the patients’ data to the EHR.
Know How for No Lost Time
There are many aspects of the patients’ workflow that we, as doctors, are not responsible for. For instance, we don’t check in the patients, schedule appointments, log vital signs, transcribe outside labs, pull device reports, check out patients, or handle prior authorizations. However, I deeply appreciate the efforts of the staff members who work hard on these things so that I can focus on medicine without distractions.
That being said, it’s important to know how to perform these tasks in case the assigned person is absent or leaves unexpectedly. I have learned to be curious and learn the details of everyone’s work. I observe, try it myself, and learn how to do it. While I won’t do others’ jobs routinely, as everyone is accountable for their own work, everyone knows that I’m competent to do it all. For the CGMs and insulin pumps, I know how to upload all the devices myself. Staff members come to me if they attempt to download them and fail, and I’ll take care of it only in these instances.
I also believe in continuous education for myself and the staff. I’m always learning something new from them and continue to teach and support them to grow in their roles. I won’t take the short path of doing it myself instead of taking the time to teach them and correct their mistakes. It’s an investment that you’ll pay upfront. If you spend the time, they’ll make your life much easier.
If you want to learn more about improving your clinic’s efficiency and effectiveness, consider reading my book, No Work After Hours, and viewing prior blog posts.
