EHR lessons learned from small practices: part 3


While this series has elaborated on several challenges and solutions for small-practice physicians of implementing an EHR solution, we have not yet discussed the possible effects an EHR can have on the quality of patient care.  With all the talk in the industry regarding meaningful use, security, compliance and cost, little has been said about how EHRs can actually improve patient care. While the prospect of a meaningful use incentive check is an attractive perk of EHR adoption, shouldn’t the main objective and focus be on improving the quality of patient care?

The government assured us that, as a result of meeting meaningful use requirements, the overall quality of healthcare in the United States would improve. Throughout the course of our study we were able to support this claim, identifying many substantial benefits that an EHR solution – when used to its full potential – can provide. For example, an EHR that offers a longitudinal view of a patient’s medical history improves the tracking and communication of things like drug interactions, allergies, lab results and even missed appointments. Having a more extensive, holistic view of patients’ medical histories leads to more efficient and improved clinical decisions — something that is particularly advantageous in the treatment of chronic conditions, such as diabetes or asthma.

Further, we concluded that patients find it extremely useful and educational when their physician is able to show them the tracking and progress of a specific condition or treatment regimen, as it can help them to recognize behaviors that may be affecting their health. Consider a diabetic patient, where the ability to track spikes in blood sugar over a specific period of time and equate that to weight gain, diet, medication or any number of factors would be instrumental.

A SaaS-based EHR solution with remote login and shared access capabilities offers immediate communication between labs, pharmacies and other providers to further facilitate the holistic treatment of patients while increasing the efficiency that critical information is shared. These are benefits that will be quickly realized, particularly with an EHR that incorporates the features and capabilities discussed previously in this series. I, along with many of my colleagues and physicians, believe that with time EHRs will lead to a much better universal understanding of the best and most effective treatments of specific diseases.

To wrap up the lessons learned from our work with the Mayo Clinic, it is important to point out that small practices really do have different needs when it comes to EHRs, and they should not be forced into a “one-size-fits-all” EHR. Customization may be the single most essential of all EHR characteristics. Small practices do not necessarily need an EHR -- they are already efficient and effective, employing clinical workflows and processes based on years of experience and evolution. An EHR that can avoid radical change by mimicking a practice’s current, proven system is most desired as it will reduce disruption in a system that is already functioning adequately while offering improvements in efficiency and quality of care that may not have even been considered.

To summarize, some of the most vital capabilities and features an EHR for a small practice should contain include:

  • An intuitive, customizable user interface to hasten adoption and utilization.
  • A customizable electronic clipboard that mimics current paper displays and layouts to decrease disruption and increase efficiency.
  • The ability to create longitudinal views of patients’ medical histories for increased quality of care and medication compliance.
  • Support for role-based logins with screens and functions tailored to the needs of each specific role.
  • Cloud-based access to enable login from anywhere, and avoidance of costly local system maintenance.
  • Quick log-in capabilities with flexible search term options and intuitive categorization of clinical data for improved access and mobility.
  • Personalized training and transition support to ease adjustments and hasten EHR adoption.
  • A SaaS-based model that allows for remote tech support and a less significant initial investment.
  • A tablet-compatible EHR to alleviate space concerns and increase mobility and usability.

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