In this excerpt from the Caring Greatly™ pod5cast, Annie Ideker, MD, a family medicine physician and Senior Medical Advisor for both Clinician Experience and Clinician/Patient Relationships in ambulatory practice for HealthPartners in Minnesota, discusses her team’s efforts to streamline EHR work and its impact on clinician well-being with Liz Boehm, Executive Strategist for Vocera Communications.
In 2020, Dr. Ideker and her team identified four key areas of focus for EHR improvement: orders redesign, documentation, best practice and medication alerts, and EMR proficiency. In each of these areas, Dr. Ideker and her team designed solutions using a data-driven approach, in partnership with clinicians, and always with the aim of making the technology effective, efficient, and even delightful.
You said that after COVID necessitated an incredibly rapid uptake of telehealth, your team recognized the technology was playing this increasingly large part of the clinician experience. You and your team took on the EHR to make sure that it was working for clinicians as opposed to clinicians working for it. Can you explain what you’re focused on and how it impacts the clinician experience?
Dr. Ideker: We looked at the landscape of what we were hearing from our clinicians, in terms of their interactions with the EHR and we looked at data.
That really informed the four key priorities that we started working on under the umbrella of clinician experience.
One of those key priorities is what we have grouped as medication dose alerts, best practice alerts (BPA), and health maintenance alerts. I think of it as anything that interrupts a clinician. The guiding principle for this body of work is that if I’m going to interrupt a clinician, there better be a really good reason.
We can systematically, again using data, tell what are the alerts that are firing most commonly, and we start with the low-hanging fruit. We are able to evaluate and analyze what’s actually happening as a result of presenting those alerts to clinicians. Then the bar is quite simple. If it’s not resulting in a change in action or a meaningful change in what a clinician does, it doesn’t meet the bar, and we take it out. By doing that, and this work has been underway now for a little over six months, but we’ve eliminated literally millions of clicks.
The reason that we have continued to calculate those clicks and hours is it has become part of our communication with our clinicians. It’s part of what we are doing as a team to help build and, to some degree restore, trust that our clinicians have with our organization around the fact that we’re making it very visible, that this is what we’re working on, why we’re working on it. We’re telling the story and we’re using the data to tell the story.
I can talk all I want to about some strategic initiative that we have, but that’s a very different conversation than if I told a clinician that I removed a million clicks from their day-to-day work. That’s the story that resonates and that’s why we continue to measure and communicate about it in those terms.
It’s incredibly powerful that you’re doing this in partnership with the frontline people who will be using these tools. They both are designing solutions that work for them, and then also potentially become champions for those who aren’t directly involved in the process.
Dr. Ideker: One of the things that our team has been trying to change is this idea that our technical people who understand how to build are in the best position to know what to build for clinicians. We’ve been intentional in all of this work about putting clinicians at the center of it and engaging our clinicians early and often and upstream in the design of what we’re trying to build, because ultimately it needs to work for them.
I really think about the fact that if we’re doing our job well and accomplishing the goals that we’ve set out, that clinicians won’t have to think about the technology anymore. It’ll just be in the background. Clinicians won’t see themselves as working for their EMR.
The EMR will work for them, but it allows us to, as clinicians, focus on why we are in the practice of medicine to begin with, which is our patients.
This excerpt has been edited for length and clarity. The full interview is available at Vocera.com/podcast/Streamlining-EHR-Work-For-Well-Being or listen on Apple Podcasts, Spotify, or Google Play Music.
The Caring Greatly™ podcast is a destination where healthcare leaders find stories and resources designed to help them to grow, lead, innovate, and rejuvenate. In an interview format, thought leaders from across healthcare disciplines share insights and inspiration about leading and thriving as the industry transforms. The Caring Greatly podcast is supported by Vocera.