Using Team-Based Approaches to EHR Usability, EHR Optimization

A multidisciplinary team focused on EHR optimization is effective at improving EHR usability and ultimately mitigating clinician burnout, according to a Journal of the American Medical Informatics Association (JAMIA) Open case report.   

It is common for clinicians and health IT experts to emphasize EHR vendor and EHR implementation. However, sustaining the technology and enhancing EHR usability comes down to EHR optimization.

Better EHR usability leads to higher EHR adoption rates, fewer clinical errors, lower clinician burnout rates, financial benefits, and improved patient safety.

A group of researchers established a multidisciplinary “EHR SWAT Team” to combat clinician burden and improve EHR usability. This team consisted of ten individuals, including one chief medical information officer, two clinical informatics nurses, three clinical applications team members, one health information management specialist, and one pharmacy informatics specialist.

These ten healthcare professionals made up a direct clinician feedback channel to express critical EHR-based challenges and have these challenges addressed, prioritized, and fixed in a timely manner, the study authors explained.

The EHR SWAT team collected and prioritized information and EHR optimization requests from their respective colleagues. Priority groups included re-education (immediate EHR training fix), quick fixes (six-week optimization), future fixes (over one-year optimization), and optimizations that are unable to fix due to technical or regulatory restraints.

Next, the group initiated meetings with the separate clinical divisions to notify colleagues of how they will prioritize the EHR optimization challenges.

The team gathered 118 total requests. Thirty-six percent of the requests could be fixed immediately through EHR training or re-education, 17 percent were graded as quick fixes, and the remaining 35 percent were future fixes.

EHR documentation, EHR workflow navigation, EHR alerts, and prescribing were the most common training requests. Increasing EHR notifications, updating order sets, adding documentation templates, and implementing autotext to ease documentation were the most common quick fixes.

Sixty-one percent of clinician respondents said the EHR SWAT team initiative improved EHR proficiency.

The team communicated all EHR optimization and status updates through a monthly newsletter sent to clinicians. This newsletter included training tips and tricks, educational materials, and status updates.

Overall, the case report emphasized the importance of leadership buy-in, clinician engagement, project management, agile methodology, and defined accountability, the researchers said. The EHR SWAT team focused on providing resources to accomplish prioritization, approval, and EHR optimization.

Additionally, the team leveraged monthly divisional meetings and responses.

Strong project management allowed the team to effectively plan, execute, monitor, and track each step of EHR optimization. Meanwhile, agile methodology allowed the team to optimize the EHR and accomplish end-user EHR satisfaction. Leveraging a monthly newsletter to inform clinicians on EHR optimizations and updates allowed for project accountability.

Looking forward, the researchers aim to implement sustainable approaches to re-educating clinicians through in-person or virtual sessions by leveraging EHR tools and literature suggestions. The research team also wants to share a detailed accountability framework for continued EHR optimization requests and future fixes to improve EHR usability.

“Embedding our initiative within the larger organizational physician engagement strategy allowed us benefits of change management and communication strategies that were already in place,” concluded the study authors. “We plan to measure the effects of this intervention on our organization’s baseline measures for physician burnout due to EHR (74.5%) using back-end usage log data and a follow-up survey.”