Are you really finished with that EHR implementation?

So, you’ve made the October 3 deadline to implement your EHR and start your reporting period so you can collect that nice little incentive check for 2011.  Now you can relax and again enjoy the Monday morning coffee and donuts that you bring in for your staff, finally confident they won’t pour the coffee on your head and throw the donuts back at you. 

Or can you?  Your medical assistant is whining about how long it takes to enter patient histories, your biller complains your EHR notes are pushing her the wrong E&M codes, and your spouse is wondering if you are truly spending all those hours at home in the evening on the computer finishing your chart notes, or if instead you’re creating a new Google+ friend community because you have lost all of your old friends while you spent the previous three months in your office implementing this EHR.

Most EHR implementations reach a productivity wall a few months in.  By this time the staff knows the software, knows the hardware, and has warmed up to altered workflows.  And then it hits, that feeling that this new process is too slow, and it won’t ever be as fast as it was before.  This is normal, so let me give you one idea of how to work through it.

Let your staff know that you feel their pain, and that you want to address their issues with these two goals in mind.  First, improve patient care.  Second, improve their quality of life.

Have each person list the one thing about the EHR that, in their opinion, most improved patient care.  Next have them list one thing about the EHR that has improved their own quality of life.  This may be the same or different things.  If there is time savings, be sure to list that as well.  After that, have them list the EHR issue which is currently most negatively impacting patient care, and the one which most negatively impacts their quality of life. Again, these may be the same or different.   And list any time deficit this is causing.

Discuss how these negative issues can be addressed, if research needs to be done (like searching for online articles, calling for EHR vendor, or speaking with staff from other offices), and in general how the staff member will own and work to solve the issue.  Agree to meet in one week to discuss how they have worked to resolve the negative issue.

At the next meeting, again have them point out one new positive feature, and then have them explain what they did to improve their troublesome issue(s).  If they have solved the issue(s), congratulate them!  Then ask them to list a new one to tackle for the following week.

If they have made progress on their issue but it is still unresolved, have them work on it for next week.  Finally, if they feel they can’t make any more progress and it won’t go away, then agree that it is what it is, and put it away for a revisit in a a couple months. 

 

This process should give staff a method to work out issues in a management supported way.  And it will also provide a constructive conduit for the inevitable complaints about how “it used to be [insert your choice: better, faster easier, more fun, more accurate] when we used paper charts.”

These meetings can be held individually or in groups, but should be kept short.  I think the key is for staff to take ownership of their issues.  Typically they are best positioned to solve them because the issues face them every day.  You can try variations of this, and I’ve seen lots of them work.  Good luck!  Please share if you have any suggestions.

Straight ahead,

Bob