Rate Your Pain: How Do EHR Documentation Solutions Affect You

One basic way to prescribe an appropriate treatment is to gauge how much pain the patient is in. What about your own pain? Have you been afflicted with the fatigue and suffering associated with using outdated medical documentation software?Alright, so maybe we’re putting a bit of a dramatic spin on it, but with the majority of physicians still reporting dissatisfaction with EHR systems in 2016, it’s clear that using the wrong systems can be a pain in the neck. In this article, we’ve collected a couple of (mock) reports based on some experiences we’ve heard straight from practitioners. Which one sounds the most like your own experience with documentation software?

5 - Just put me out of my misery

Hours spent in medical documentation software:

None, now. I’m switching back to paper tomorrow.

Describe your EHR usage:

I come into the office, and boot up my computer. It seems like there’s a software update every day. I usually head to my first appointment while the software is spinning up, so I haven’t had a chance to review their chart in the system. Instead, I rely on my hand notes from the last visit, and question whether I should continue paying for the EHR.

During my patient exam, I take handwritten notes, as usual. My office admin was having trouble reading my shorthand, so this takes awhile during my exams. The patient is polite, but it’s clear they notice when I ask them to repeat some of their information, and it’s pretty embarrassing. The exam runs over by several minutes as I complete the notes, so I don’t have time to check in on my EHR and enter data.

This happens in a cyclical manner until the end of the day when I no longer have patients scheduled, at which time I go back to my medical documentation software and enter all of the data. This is a terrible use of my expertise and time, and it forces me to eat dinner alone at the end of the night. I know I’ll be missing out on the incentive payments if I drop the system from my routine, but I’m going to go crazy if I have to keep working like this.

4 - I need anaesthesia!!!

Hours spent in medical documentation software:

1 hour per patient

Describe your EHR usage:

I always seem to get into my system alright, but once I’m in there I quickly get tangled up in the navigation between patient records. My EHR is extremely modular, with layers on layers of field entries, and it seems like every piece of data I need to enter for a given patient requires me to open up a new window or reload a page. I have a desktop computer where I do a majority of my data entry post-visit, but I am able to carry around a laptop into the exam room to gather details directly with the patient.

While I’m in with a patient, I usually have trouble hearing what they’re saying over the clacking of my laptop’s keyboard. I usually only make eye contact when I first greet the patient, and we always have to get straight to the questions I need answered in order to update their chart. By asking the purpose of the visit, I get the unknown information entered during the exam, though I only have time to use abbreviations.

After the appointment is over and I have some free time, I go back and expand on my shorthand to add in details from memory. I’m pretty sure that information is accurate most of the time, but it is very possible that there are some errors with past info since I don’t really have time to follow up on those details during the exam. I know I’m not really delivering the best care I could, but at least I’m keeping up with record maintenance.

3 - I couldn’t sleep through this pain

Hours spent in medical documentation software:

1 hour per patient

Describe your EHR usage:

I would say I struggle a little with my EHR software, but for the most part it’s usable. I did some work with medical billing systems in an internship prior to medical school, and I see some similarities in the layout of the programs. If you just think of your patients as objects or business deals, the system makes a little more sense. That’s not necessarily helping me deliver quality care, but it at least gets the data entered.

I spent a couple of weeks working with a medical scribe to train her on the system, and now I bring her along to my exams so she can observe and record the patient’s responses while we go through the appointment. This tends to make some patients uncomfortable but I’d much rather record accurate data than risk missing details by completing the charts on my own. In the end, this doesn’t actually save too much time for me (not to mention the expense) because I don’t have more context with the patient than my colleagues, and I always go back through the system at the end of the day to check on the details.

I’ve been pretty successful at meeting meaningful use requirements and preparing for MACRA, but I still think my practice is lacking. I’d be interested to see what my patients’ satisfaction scores are. I guess EHR isn’t my worst enemy or anything like that, I just think it takes away from the quality of my patients’ experience.

2 - I’m experiencing some discomfort

Hours spent in medical documentation software:

30 minutes per patient

Describe your EHR usage:

I had been looking for a way to eliminate communication barriers between me and my patients at exam time, and it was quickly clear that bringing a laptop into the room and typing away was one of those barriers. After checking back with my EHR vendor, they said they didn’t have a mobile-ready version of their application, but that other users were able to use the system well enough on a tablet PC. Since switching to a tablet, I’ve noticed that communication definitely comes easier with my patients. I can make regular eye contact and engage them without much difficulty. However, the system still has its faults.

For one thing, I’m pretty sure there isn’t any difference in the software while it’s on my tablet. I’m still typing things out, and tapping feels a lot like clicking, which I do a lot. It really doesn’t feel like any other apps I use on my smartphone or iPad®, and I guess I’d describe it as “clunky.” I definitely wouldn’t be able to use this software on my phone, since everything just shrinks down.

While I can get a lot of information down and maintain a good level of rapport during my visit, I do usually have to go back and correct small things like spelling mistakes. There have been a few occasions where I’ve found autocorrect mistakes. My device’s built-in keyboard makes fewer mistakes as I go along, but I’m worried about the one time that I miss that sort of thing.

1 - I’m feeling just fine

Hours spent in medical documentation software:

Completed by the end of, or just after, the visit

Describe your EHR usage:

My documentation software really doesn’t impede my ability to do my work. If it’s a regular day, I show up on time, I leave on time, and I feel like I’ve put in a good day of interfacing with my patients. The trick is that I don’t really use my EHR directly (that would be a challenge), but I recently switched to a mobile EHR app. Basically, the software’s design and interface has been rearranged so that I can use intuitive touch-capable features like swiping and scrolling. The system is also pre-loaded with all of the medical terminology I use on a regular basis, so I actually do very little manual entry and it’s actually difficult to make errors. When I do need to input some custom language or descriptions, I just activate the voice recognition feature and build a narrative about the patient’s visit just by speaking to my device, regardless of whether it’s a smartphone or tablet.

Since I’ve added a mobile EHR app to my workflow, I’ve really felt closer to my patients and able to do what I was trained to do: practice medicine. I’ve also had a lot of success with getting some of my less compliant patients back into the office because of the automated text and email feature in the app that sends out appointment reminders.

My practice has a lot of tired and sick faces coming in, and smiling faces leaving. That’s what I’ve always strived for, and I’m really pleased with that my documentation process supports my work instead of getting in the way.

The Recommended Treatment

Want to find out how you can drop your own EHR pain score down to a one? Get acquainted with the mobile EHR app that addresses all of the common complaints that physicians have regarding their documentation software, iScribe. Learn how iScribe can address your specific EHR challenges. Click here to try iScribe.

 

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Author:Pat Williams

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