Adapting to EMRs and EHRs –The Way Clinicians Work Matters

Significant discussions around EHRs and EMRs have been going on now for quite some time. And while there are many pros to this new type of patient tracking, we also know there are cons that make healthcare professionals a little more hesitant to adopt EMRs and ERHs with open arms. However, we believe learning from others’ experiences as well as leveraging space in a meaningful way can help ease at least some of those concerns.

Still Transferring to EMR or EHR?

On HealthIt.gov, there is an enormous amount of information about EMRs and EHRs. The site is helpful in shedding light on many topics regarding EMRs and EHRs.

One particularly helpful area of the site is a compilation of lessons learned from the Regional Extension Centers (RECs) and their EHR Implementation and Project Management Community of Practice. It’s a collective capture of experiences of implementing EMRs throughout the country.

Lesson highlights include:

  • Lesson 1 – Identify and coordinate with the local health information exchange (HIE) in your area
  • Lesson 2 – Rapid transition from paper charts to EHRs helps ensure success
  • Lesson 3 – Conduct chart abstraction before “go-live”
  • Lesson 4 – Cut back on patient load during “go-live” period
  • Lesson 5 – Make training a priority

 For more information, be sure to read the in-depth version on HealthIt.gov.

Already Switched to Digital EHRs and EMRs?

If your organization has already implemented EMRs and EHRs, chances are you’ve encountered some growing pains. Transitioning from paper charting to electronic charting, navigating between paper notes and digital notes, and even learning to record data during appointments while continuing to be patient-focused are all part of the challenges presented by EMRs and EHRs.

There’s a bit of a delay for most organizations with the transition from paper to technology — not only in the physical transition of how to chart and record, but also in registering the benefits. In one way, paper charting was simpler.  The question of impact on productivity is still under debate.

Yet, on a different level, EMRs and EHRs enable a level of transparency that can benefit patient care beyond what paper charts could ever do.

As mentioned in the previous post, The Age of Digital Healthcare — A Closer Look at EMRs & EHRs, the benefits include:

  • Comprehensive patient records, easily accessible by patients
  • Ease for medical team collaboration
  • Ease of access for care providers to all medical data

Integrating the Technology

While I’ve seen many care providers utilizing electronic records, either medical or health, the one observation I’ve noted is how differently they all are using the technology.

It’s not just the typing skills I’m observing. And, yes, some people still henpeck to enter patient data, which makes appointments longer. Others still don’t quite feel comfortable recording the data electronically. I can tell by the things they say out loud as they conduct appointments, such as “Wow, I didn’t click that” or “I didn’t know that was an option.”

Most of all, I’m surprised at the way many care providers incorporate laptops or iPads into treatment rooms. My experience of late has been with office appointments vs. acute care, fortunately, but I’m still surprised. I saw one nurse sit in a non-ergonomic chair, similar to an old-school waiting room chair, crouched next to a low-level table squeezed next to a door, entering in data. At another office, the experience was similar, with the exception that a rolling stool replaced the chair and it was farther away from the door.

I was impressed at my daughter’s pediatrician’s office. While the nurse used the exam table as a desk for her laptop to enter her data, the physician did arrive with a mobile cart. A vast improvement by the physician over all the other technology users and care environments I’ve recently encountered.

Supportive Environments

Why would care providers, who know the effects of poor posture, put themselves and their staff at risk? Has the implementation of EMRs and EHRs come so quickly that there has been no time to prepare or create more supportive environments for the technology?

Undoubtedly, the answer is no. My guess is that the care providers don’t know there are other options, such as a better chair or an adjustable rolling cart. And, since their specialty is medicine, why would they? It’s up to the facility manager.

Additionally, how are existing facilities expected to invest in all that’s required for EMR and EHR and consider an investment in support furniture as well? So it appears that many organizations are just trying to make it work by retrofitting all of it into the existing infrastructure.

The truth is, the cost of not supporting the technology will come later. And care providers will pay the price just as office workers have done for poor ergonomics. We’re not suggesting a huge facility overhaul, but consideration of methods to support technology use. Whether it’s a mobile cart or supportive chair, there are many options. After all, we’ve done the research at Steelcase Health to know that the right support and environment make a significant difference.

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