5 Ways We Can We Improve EMR Software
Prior to my venture into the tech field, I was an Emergency Medical Technician. I carried a clunky netbook with me at all times, installed within it “Sunrise” and later “Epic” systems, both of which are EMR (electronic medical record) software. A large part of my time was spent futzing around with this software, lamenting its inefficient and buggy nature. I logged more time typing into text fields and clicking off radio buttons than the time I spent with the patient. In this grand technological era, where complex technologies like machine learning and artificial intelligence are rampantly revolutionizing the way that we interact with the world and each other, there is a fundamental oversight in its application in the healthcare world, a domain that needs technology the most.
Providers spend hours each week sitting in front of a computer, entering patient records using EMR software. They are responsible for documenting a myriad of information; patients’ conditions, treatments, lab results, outcomes. This software was designed to alleviate “physician burnout”, efficiently and effectively track patient data, and improve the flow of the workplace. The reality of this is quite the opposite. Providers are spreading their time thin, frantically shifting between tedious documentation and seeing the next patient; compounding an already long list of unfinished charts. To compensate for this drawback, hospital systems are spending thousands of dollars on medical scribes, on top of the hundreds of millions per year for the EMR software. These medical scribes function as the middle man, using the EMR software to document for providers, yet even the scribes have raised their concerns about its rigid, bloating, and capitalistic nature. A well-known example being the countless, sometimes needless buttons that require clicking off, and form structures that make documentation inherently time consuming. It is quite evident that this software is not primarily designed to be a clinical platform, but rather a billing/risk management software.
Providers should be able to prioritize patient focus over documentation and billing. What are ways that we can make this software more accessible, intuitive and provider-friendly?
- Improve dictation technology.
The natural way for providers to communicate is through dictation. When we physically observe a patient, there is subconscious analysis going on that extends deeper than a few click-offs and a quickly summarized statement. The effort it takes to type all of this information in is much to the chagrin of providers. Although dictation devices are used, they are often so inefficient and inaccurate that a provider will settle for staying after hours to finish charts in the absence of a scribe. Improving the connection between dictation devices and EMR software could make documentation far less laborious.
2. User-centered design.
Developers should frequently obtain user feedback from providers at multiple stages in development. Using evidence-based feedback from prior iterations could be useful in assessing the successes and failures and figuring out what the common pain points are. This can help developers identify any communication gaps and utilize resources from providers. A useful example of this in practice would be to shadow providers during their work day and take note of how they are interacting with the software.
3. Search functions.
As EMR software grows and becomes increasingly more complex and encompassing, providers often struggle trying to find specific form. For example, a provider might document “purple stool backflip” in the notes section, and then later be told that there is a special purple stool backflip sheet that they are supposed to use. More search functions could be implemented to save providers the time and trouble of memorizing exactly where everything goes.
4. Lag time.
The most frustrating thing a provider can experience during documentation is excessive lag time followed by a system crash. This happens way too often and valuable notes are often lost. This is a huge pain point that providers just adapt to because it has become the norm that EMR software is slow and prone to bloating.
5. Personal tags.
Most providers remember patients by details that there is no free text area for in some EMR software; “the one with the angel tattoo on their back”, “the one that doesn’t like painkillers”, “the one that is grieving over a recent loss”, etc. EMRs could integrate more free text areas or “tags” that are solely for the provider. Some vendors have been implementing “sticky notes”, which has been viewed as highly useful and favorable amongst providers.
These suggestions were culminated from both my personal experience and anecdotal reports from other providers in healthcare. The big unicorn in this endeavor remains that providers want EMR software that is more geared towards provider usability instead of billing.
