Six Mistakes to Avoid When Building Your EHR System

As a specialist eHealth software developer, Intersog collaborates with practicing physicians and medical professionals on each custom Health IT project we're working on. Having talked to a few of our healthcare consultants, we've figured out 10 traits of existing EHR systems that irritate medical personnel the most. In general, it was sad to find out that most of today's EHRs don't live up to their promise of streamlining patient care and facilitating work for medical staff. Instead, most of doctors in the United States we partner with on a regular basis believe current EHR systems add more work hours and headaches to hospital personnel.

As one of our interviewees puts it, "I don't have enough time to finish my electronic documentation during regular work hours, so I usually spend my weekends and day-offs finishing up my EHRs. So do most of my colleagues." But do you, as a patient, want your doctor to work in their spare time and suffer from burnout as a result? I think most of patients want their doctors to rest well at their weekends and love providing care. That being said, today's EHR systems are still lagging far behind ease of use and other goals they are meant to attain.

So, what 6 mistakes should you avoid when building an EHR / PHI system (based on pissed off physicians' feedback)?

Avoid too many clicks and scrolls in the EHR system

Did you know that today, most of physicians spend 44% of their day doing data entry work vs 28% of the day they spend with their patients? The average EHR system takes more than 30 clicks to order and record a flu shot, i.e. over 4,000 clicks during a 10-hour hospital shift. In some systems including Epic, Cerner, or McKesson it takes on average 21 clicks, 8 scrolls and 5 screens to just generate a billing invoice. Each extra click or scroll adds up to work intensity, so when you build your own EHR system, make sure you limit the number of such events to the minimum! Ideally, each action should be executed with no more than 2 clicks.

Make sure your EHR system's workflow fully meets physician needs

One of the doctors we've interviewed complained that when using EHRs deployed by his hospital he can't look up any clinical data while dictating his note. It means he has to rely on memory as well as x-ray reports and medication lists in order to reference these data points in his clinic note. Make sure to design multi-functional screens and screen splits to add ease of use for physicians and, again, save their time from making extra steps in the system.

Making EHR systems modular will allow medical personnel to configure their health IT environment to best suit their workflows and patients.

Make sure your EHR system provides team care support

That's pretty clear that oftentimes, both a physician and a nurse or assistant need to add documentation to EHR systems. But today, many systems are configured so that each user has to log in and then log out before someone else can contribute to the same record. Whenever doctors and nurses log in and out, it adds up to 5 minutes of extra work to their daily routine. In order to be workable, the solution should allow for autonomous and simultaneous use by different parties. Make sure to designate different user roles and assign certain permissions and restrictions to each.

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Avoid long sing-in process

Most of today's EHR systems have a long sign-in process that adds up to 15 minutes of extra work a day (remember that doctors and nurses have to log in and out of the system several times a day?). Many doctor we've talked to believe the sign-in process should be simplified to tapping one's badge on the screen. So, do take advantage of object scanning tech as well as touch and voice recognition technologies when designing system sign-ins.

Reduce cognitive workload on doctors

As we already know, physicians spend significant amount of time navigating their EHR systems. But what else adds up is a cognitive workload. Doctors we've interviewed agree that most of clinical data available to them through EHRs is unstructured, succinct and poor in quality, which makes data interpretation difficult.

As one of our interviewees puts it, "I once had a patient who I sent to another clinic for additional testing. I got back a large note, about 15 pages long. And still I didn't know if she had cancer."

That being said, the lack of context and unstructured data prevent physicians from making decisions based on context sensitive and concise data. To achieve this, EHR software developers should create additional tools for data discovery, analysis and visualization so that the average doctor can easily understand the contents of each clinic note they receive. These tools should be customized for each medical practice environment.

Make sure your EHR system facilitates digital patient engagement

Most of today's EHR systems aren't designed to support digital patient engagement. As you develop your EHRs, make sure you incorporate interoperability between a hospital, patients' mobile tech and virtual communication technologies to better promote health and wellness as well as manage chronic diseases.

Check out how Intersog develops digital patient engagement when building custom eHealth application for our clients.