3 EMR Power Tips: 3 Things That Will Drastically Improve Your Workflow
“All I seem to be doing is charting,” Dr. Elaina (name changed for anonymity) cried. “I spend 3 hours after work, and then I go home and spend another 2–3 hours after I put the kids to bed. Sometimes I don’t get to bed until 1 or 2’oclock in the morning. I’m even charting on my days off and over the weekend. It was the second story I had heard that week from physician clients who’s overwhelm and burnout was stemming directly from the work they were putting in on charting alone. While many physicians I speak to about this, tend to blame the EMR’s, the real problem is not the system (although there are some horrible systems out there). The real issue is that most doctors lack the training, tools, and skillset that can make them EMR Power Users! Most physician EMR trainings are barely bare bones, and assume that the doctor already is “computer savvy” therefore setting them up for failure and complete frustration. Furthermore, there really are no classes, courses, or trainings that truly gives physicians the skills they need to make charting faster, easier, more intuitive. Bottom line, with little resources and training, it’s no wonder most doctors DESPISE Electronic Medical Records today.
If you are not a power user, I’ve put together the following tips to help you to begin to improve your EMR charting efficiency, hopefully giving you back some time, freedom, and peace of mind:
#1 — Use Templates. The fact is that if you are charting any more than 20% of your note, you are not efficiently making use of your templates. Now I know some EMR’s have robust templates and others have barely anything to work with. I’m also aware that some EMR’s are more customizable than others. The key here is to create your own templates. Make a list of the most common things you see in patients and start there. You may be saying at this point, “I don’t know how to create a template!” There are two ways you can approach this:
a. Call I.T. — Once you get the list of conditions you know you’d like to make templates for done, you can call your I.T. department and have them help you create them one by one.
b. Find someone in your office that is a Power EMR User, and ask them if they would mind showing you how they created their templates. You can take it a step further and ask if you could take a look at their templates to see if they would be a fit for your use. If so, simply ask them if they would mind sharing their template with you and showing you how they made it work for them. They will most likely be happy to share their knowledge and expertise in that area with you. This way is, I believe, will yield more favorable results as you may come out with templates for conditions you hadn’t even thought of before.
#2 — Chart in the Room with the patient
Where many physicians get stuck is the process of charting while in the room with the patient. Doctors have said that they don’t want to be head down in the chart when they could be connecting with the patient. This is a completely valid argument. Others have complained that they are not great typists, so it’s not efficient to chart in the room (see point #1).
One of the things I do that allows me to quickly make notes in the chart, while leaving the patient feeling heard and valued is simply communicating my documentation process. It sounds something like this: “I’m just going to make a little note so I make sure I completely get what you said.” Or “I just want to make sure I remember what I’m telling you to do for next time ” (you can use this one if you are making notes on the assessment and plan section) or even “Let me make a little note to makes sure this mind doesn’t forget something important you said.” This statement lightens the mood and pokes a little fun at yourself, which humanizes you increasing connection. Using empowering language in this way lets the patient know that what they are saying IS important to you, that you care, and that you are stopping to document for THEIR benefit .
#3 — Training the Staff to work Intuitively with You
In my residency, we did not have our own nurses. We typically worked inside a 1:2 ratio, and sometimes 1:3 ratio in our clinic (depending on how busy we were, and who had called out that day). However, what made the workflow so efficient even when we had a “half” nurse, was that our nurses were trained in to work intuitively with the doctors. They would put the likely orders in based on the type of patient visit or patient presentation. It decreased the amount of “clicking” we had to do during the patient visit after the note entry, and got the patient out on time without them feeling ignored or rushed.
Over the last 15 years, I’ve tweaked and refined my processes, however I have found that the of all of the tricks I’ve learned to make myself more efficient with charting, the three tips above were the foundation, from which have blossomed. Additionally, I have had the opportunity to spread the wealth to other physicians over the years transitioning them from “hater” to “EMR Power Users”, and further deepening my own perfection process. My final advice is to first shift your mindset. EMR’s are truly not the devil; inefficient charting is. Implementing the tools above, you may find yourself beginning to soften your view on EMR’s once you are getting home on time and not spending hours of family time finishing charts.
