No one will argue the need for precise and accurate medical records. Doctors, surgeons, clinics, and hospitals need to be able to access patient data quickly and easily in order to effectively treat patients. However, the EHR process in many hospitals and clinics could use improvement. A recent article in Modern Medicine outlined four steps to improving EHR protocols. In this article, I’d like to go through each and offer my own insight as a practicing surgeon.
Cut Down on Doctors’ Administrative Tasks
Let doctors do what they do best – diagnose and treat patients. Most doctors and surgeons work crazy hours to meet patient needs. Adding hours upon hours of administrative tasks like data entry not only takes away from their time with patients – it can also lead to burnout. Rather than having physicians manually do data entry themselves, they should focus on dictation, which can then be vetted for accuracy. This can speed up the process and improve the overall experience for doctors and patients alike.
Structured vs. Unstructured Data
It’s essential to find a balance between structured data and unstructured data. Structured data is required for certain entries like demographics, vital signs, and medication lists. But many EHRs also require structured formatting far beyond what is required. Having a mix of structured and unstructured data will make work flows more efficient.
Get Rid of Interface Barriers
Interfaces allow EHRs to communicate and work with other systems. However, EHRs often charge hefty fees for these interfaces that then discourage doctors and clinics from utilizing these services. These interfaces should be cost effective and readily available to any system.
Editing & Transcription
Having physicians dictate patient notes is great, but that audio needs to be transcribed and edited to ensure full accuracy. It’s important to have an expert handle these services – whether you outsource them to a third-party transcription company, or handle them in-house.
If you’re looking for practical ways to put these tips into practice, checkout SurgeonMasters for educational tools, webinars, and meetups that offer excellent strategies for burnout prevention and surgeon wellness.