Think back to your go-live. Providers were working hard to learn the new system and get ahead of the curve, and you expected that once go-live was over, you would return to pre-live volumes and efficiency. Unfortunately, data is showing what your organization may intuitively know: even years after go-live, provider efficiency hasn’t recovered. In order to make up for some of these inefficiencies, providers are spending more than 10 percent of their time in the EHR after hours.
Rather than closing encounters, finishing notes, and reviewing their In Basket in real-time, providers are pushing core documentation tasks to end of the day and staying in the system longer than needed.
As concerns grow regarding provider engagement and satisfaction, you’re likely trying to keep providers happy without sacrificing quality documentation. When providers spend less time in the system, they spend more time with patients and enjoy a better work-life balance. But does less time in the system mean lower documentation quality?
Absolutely not.
Epic's tools have evolved significantly over the last few release cycles, streamlining documentation and reducing clicks, especially for common tasks. But customizing your toolsets for maximum impact requires resources in a time when your Epic team is being pulled in all directions by MACRA and population health, organizational expansion, and revenue cycle success.
You know your EHR will be with you for the long term, so how do you maximize your tools and give your providers the help they need?
At Nordic, we work with many healthcare organizations that are actively tackling this problem head-on. Here are a few of the challenges we encounter in provider efficiency engagements — and some specific suggestions to help you and your organization move towards happier providers and quality documentation:
Problem No. 1: Your providers are spending too much time reviewing the chart
Based on data from multiple Nordic clients, providers are spending, on average, nearly 20 percent of total system time on clinical review — and that’s before they even see the patient. Much of this time is spent searching through the chart to find what they need.
Solution:
1) Chart search was released in 2014 to allow providers to quickly search diagnoses, medications, or other providers. Like a Google search, this feature can save providers time and clicks by quickly jumping through the chart with a simple keyword search.
2) Building out clinical decision support capabilities will save time and improve patient outcomes. Decision support tools can be embedded at the point of care to easily notify providers of open care gaps and provide an easy way to close these gaps.
3) Synopsis is recognized as a best practice over traditional flowsheets. Many organizations have included it in their more recent upgrade but haven’t done the customization required for specialties to use it effectively. Intentional provider content review and customization of this tool could potentially save between one and two minutes per patient.
Problem No. 2: Your providers have too much information in their In Basket.
We can all sympathize with email fatigue. When you originally set up In Basket, you probably did so with an inclusive perspective, thinking, “Let's make sure the provider is included on that In Basket folder; it couldn't hurt for them to see it.” Since go-live, you’ve realized that providers are receiving too much information in In Basket without a clear understanding of responsibilities, causing confusion, delays, and double work.
Our data backs this up. On average, nearly 12 percent of system time is spent managing In Basket. In most cases, the Epic tools that can streamline that work aren’t being used.
Solution:
Quick Actions is a simple and effective tool to automate the work in In Basket. By reviewing your In Basket registry and folder structure as well as your refill process and implementing Quick Actions, we estimate providers could save between three and five minutes per day.
Problem No. 3: Your providers are spending too much time documenting reoccurring visits.
For many of your specialties, reoccurring visits (e.g., same patient, same primary diagnosis) make up the majority of daily encounters. In each case, nearly identical documentation is required, even if it’s the tenth time the provider has done the same visit or seen the same patient.
Solution:
Express Lanes, a streamlined and focused tool released in 2015, streamlines your orders and documentation to decrease system time. To maximize success, it’s key to commit the content development time with your specialists. With sufficient customization, Express Lanes can help save between three and five minutes per provider per day for reoccurring reasons for visit.
If provider burnout is a reality at your organization and mitigating it a priority, consider taking steps to combat the burnout and take advantage of the tools provided in Epic. By investing in efficiency, you’re investing in your providers.
