EMR Workflows – How Essential are They?

Long gone are the days when an EMR was recognized as a mere documentation system. Electronic medical records over a period of time have evolved into EMR workflow systems. The workflows allow for EMR customization which reflects on practice clinical needs, personal preferences and business requirements.

Workflow Management with an EMRAll electronic medical records have workflows but the more effective EMR is the one which defines its workflow for optimum output. These definitions reduce manual navigation for the user and increases productivity. Ultimately, the effect of workflow management technology on productivity is pragmatic. A recent survey was conducted on the impact of an EMR workflow management system on usability and productivity in numerous practices. The results were based on (revenue, billing, charges, visit, quality review, staff/provider ratio, charting time and refill turnaround time). The results show Increase in revenue, billing, visits and visit charges, and quality review scores while equally there was a decrease in staff/provider ratio, charting time, and phone message and refill request turnaround times. The survey suggests that the combination of workflow management and patient charting can greatly increase user satisfaction, return on investment, and practice productivity.

EMR SurveyAnother survey conducted by AMIA describes how improving EMR usability can help prioritize improvements in EMR workflow based on human factors engineering. Assessing the usability along with proposing required amendments in EMR systems was one of the fundamental objectives of this approach, which would eventually improve operations and streamline practice workflows. There were various ways of approaching this development, such as conducting studies that would involve physicians to quantify time spent on EMR based clinical documentation. Another way was to ascertain the amount of change in existing workflows when utilizing electronic medical records, by carrying out a research study of physicians migrating to EMRs from paper records. Similarly, a number of physicians were selected to identify and evaluate the factors influencing human behavior and reaction to improve the usability of EMRs. Lastly, another method incorporated a task analysis to replicate alternative approaches, along with establishing opportunities to improve functionality.

Studies were implemented in series fashion in order that insights from one study would serve as inputs to the next. For example, the first method illustrated that majority of the physicians were trying to document clinical findings and other documentation during the patient encounter. However, it was determined that regardless of the approach used for clinical documentation; physicians would be unable to document tasks performed during the actual encounter. Therefore, the groups began to focus on the development of systems which allowed clinical assessment and tasks performed to be recorded during the patient encounter.  In the end, the aforementioned methods proposed several different types of projects that would enhance the usability of EHR systems.

There are very few EMR’s in the industry that produce such productive workflows. EMR workflows are all about the user, creating the right workflows, which are well defined and effective at the point of care.


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