The Data Entry Bummer with the Electronic Health Record (EHR)
"It slows me down!"
A lot of professionals complain about entering their notes and other consumer care documents into the Electronic Health Record (EHR), saying it slows them down, or they don't have time, or something of that ilk. My experience with this issue is that once the EHR is properly in place, it saves time and the professionals actually start to like it. I even hear comments from consumers that they like the idea of collaborating on their treatment plan and knowing what the next steps are going to be when they show up for their next session (a handy use for the EHR).
It's true, however, that the EHR can slow professionals down for at least a few reasons:
1. Process Analysis of how people work before the software is even purchased can be deficient...it's easy to rush through this, and we shouldn't; this exercise provides information on how to build a better mousetrap...uh, EHR
2. Design of the EHR is faulty, and doesn't account for how people work very well
3. Implementation of the EHR was lacking and didn't shoot for the goal of minimizing the amount of work a person has to do to get the consumer treatment documentation into the system
The good news is that all these shortcomings can be avoided.
Process Analysis is simply following a consumer through treatment and seeing how the professionals' documentation is captured before the EHR comes into play. Process Design for efficiency uses the analysis and needs a couple very important tools to enable the EHR to work to the advantage of the professional: The screen designer and the report writer (other tools like treatment team and consumer communications software are great, but these two tools are the foundation of designing a working system). Process Implementation actually pulls together an EHR design that makes documenting services less time and effort consuming.
So, if the EHR really can save professional time, provide treatment team communication and help deliver better treatment to the consumer, how come so many professionals resist using it? I'm sure there are hundreds of excuses and a number of valid reasons not to use the EHR, many related to specific technology problems that could be remedied for a price. Other than that, professionals would rather treat consumers than learn to use an EHR…or improve their keyboarding skills.
There are a bundle of solutions out there to address professional resistance to using the EHR, and one is a marriage of low-and-high tech: The Remote Scribe.
Imagine, if you will, you're in a session with your psychologist, and there's a large screen on the wall that displays your EHR. You answer questions in an assessment, or talk about the plan to treat your difficulty, and the screen starts displaying the assessment selections or typing magically appears during the session. Interesting.
The high-tech portion of this solution is the simple presence of the EHR in the first place. The low tech portion of the solution is that the notes are relayed via a headset and microphone to a "Remote Scribe" (a human being). So, another data entry person is on the payroll. Not a new twist, this is getting the same old documentation solution back into the healthcare arena. The scribe has been called a transcriptionist for many decades, and some professionals would rather retire than move away from this sort of medical treatment documentation service. I suppose it's a valid way to keep technology resistant professionals working, but it strikes me as paying double for documenting services, which is the data entry bummer. Even if the Remote Scribe delivers a return on investment, it's still adding a task into the mix that doesn't need to be there if the EHR is designed and implemented with efficient and effective professional workflow and with the consumer's best treatment in mind.
The simple solution, and a much more valid one for my money, is to follow the direction of the EHR that's moving us toward National Health Record and better care for consumers with the help of technologies enabling electronic sharing of consumer records in order for professionals to treat the person as a team.