How Clinician Engagement Can Fuel EHR Implementation Success

With 32 years of health IT experience under her belt, Michelle O’Connor, MEDITECH president and CEO, has found the secret sauce to EHR implementation success: clinician engagement.

A well-crafted EHR implementation project plan should engage physicians from the early stages of the health IT’s design to its eventual rollout, O’Connor told EHRIntelligence.

Insight from practicing physicians is extremely valuable, O’Connor noted, as it helps ensure that the EHR system is designed in a way that is beneficial to end-users.

While EHR systems aim to aid clinicians in providing streamlined care, research has revealed that the health IT can lead to clinician burnout. Usability issues may include burdensome EHR documentation processes, cluttered interfaces, or a high number of EHR alerts.

In effort to provide EHR products that mitigate these causes of clinician burnout, O’Connor explained that the health IT vendor has taken a user-centered design and implementation approach.

First, MEDITECH directly employs practicing physicians to work alongside health IT developers, analysts, and designers in the early development stages.

Health IT designers also round with physicians to understand what tools they may need, and when they might need them.

“We've learned that we have to understand what physicians do and how they do it,” O’Connor said.

This user-centered design approach allows MEDITECH to tailor the technology to different kinds of provider settings, she explained.

For instance, O’Connor noted that the vendor provides ambulatory physicians with several EHR access points to optimize their clinical workflow.

“For ambulatory physicians, we give them a tablet,” she said. “As they're walking into their office, they can see the patients that are ready to be seen.”

The health IT vendor also provides clinicians with a phone for remote EHR access, she added.

The user-centered design approach also boosts EHR optimization, as designers and developers learn first-hand what kind of data physicians need and when they need to see it. This helps to ensure that providers’ screens are not flooded with information that is not relevant to their care decisions, O’Connor said.

With recent interoperability regulations set to expand provider access to patient health information, O’Connor explained that ensuring providers are not overwhelmed by the volume of data in their EHR workflows will be key.

“It's going to be very important for all of us long term to understand that more data is going to have to be filtered so that we don't get too much burnout for these physicians,” she noted. “We're all going to have to watch for the amount of data clinicians are going to be fed. You don't want to give them too much, but you don't want to give them too little.”

A new predictive analytics solution from MEDITECH, Surveillance, aims to reduce clinician burden by flagging actionable data points.

“As data is changing, we have toolkits that we can queue up a flag for a nurse or a physician of something that might be pending,” she said.

For instance, instead of having to review an entire patient chart when a new lab result comes in, the system can provide clinicians with the differential of the new lab result compared with the prior lab result.

O’Connor also noted that while MEDITECH’s recent connection to the Apple Health Kit will boost providers access to patient reported health data for more patient-centered care delivery, MEDITECH must ensure the data is delivered in a way that does not interfere with provider workflows.

“The more clinicians can understand what's happened to a patient outside of what they're seeing them for today, the better care that they can give,” she said. “We will have to make sure that the data is presented well within the workflow of the physician.”

User-centered design will help the vendor ensure data is presented in a way that is beneficial to providers, O’Connor noted.

Additionally, O’Connor explained that successful EHR system implementations allow for provider customization.

“We've realized that organizations want consistency in how the EHR is used, but each physician might want some personalization to their system,” O’Connor said. “Through the use of widgets, order sets, favorites, and more, we've allowed individual physicians to tweak things.”

She also noted the importance of strong executive and clinical leadership when it comes to EHR implementations.  

“As we're installing our systems, we want the organization to have governance up front to do the implementation,” O’Connor noted. “We have a clinical leadership program that we start off all of our implementations on.”

O’Connor has found that EHR implementations with strong executive and clinician engagement are more successful than implementations at care organizations without strong engagement.

“We have found that peer-to-peer engagement is the best way to get physicians involved,” O’Connor said. “If you don't have the right resources or the right mentality going in, it's not going to come out successfully. The only way to do that is to have everyone actively engaged during the EHR implementation.”

EHR implementations are massive undertakings that change countless processes within a care organization, she noted.

“More and more organizations are seeing it as a transformational implementation for the organization,” she said. “If you're taking out your existing system and you're putting in a new system, it's going to change how you run your business, pay your people, collect your charges, deliver care; everything is impacted.”

O’Connor noted that the more people who appreciate that the EHR implementation will change how the organization runs, the greater chance the health IT will be successful in alleviating clinician burden and enhancing care delivery.