The Electronic Health Record as a Service Tool

I have been in a couple of different physicians offices the past couple of days. I have noticed computers mounted on the wall in anticipation. There is excitement in the air. One of the phsyicians that I visited was very excited about the transition of the electronic health record and the other physicians point blank said for them to transition to the electronic health record that it would never happen. I see this wide difference of opinion about the use of the electronic health record almost every day that I am out in the field as a consultant. So many physician’s practices and hospitals do not see the real benefits of transitioning to the electronic health record. The electronic health record can really be a great service tool. I think that you will agree that most hospitals and physicians practices are truly concerned with patient satisfaction. Let’s face it, without the patient (the customer) there would be no need for a hospital or doctor’s office today. Most physicians and hospitals are concerned about their patients and if they are satisfied with their care. Some clinics will even go so far as to ask the patient to complete a questionnaire after their visit. They want to find out what the patient thought of their experience and then the clinic uses this information to improve their services.

In my visit with these two specialty clinics, I noticed that neither practice had the electronic health record fully implemented. They both relied on the paper record. Neither clinic used a transcriptions service they made hand notes in the records. I noticed that one of the clinics had signs addressing information that they were getting ready to transition to the electronic health record and that it was coming soon. I noticed that this particular clinic, the physicians and clinicians had lap top and they were inputting information. I visited two different physician practices on one particular day and here is what I found. Each of these practices was specialist. One was a rheumatoidologist and the other an endocrinologist. I will call them clinic A and clinic B so that I explain their unique take on implementing the electronic health record for their particular situation. I will also give you a list of how the electronic health record can be a great service tool.

Let’s start with Clinic A. Clinic A is the practice that is close to implementing the electronic health record and they had signs up in the waiting room for the patients to note. I noticed that Clinic A’s personnel addressed each patient by name and told them their name when the patient and family arrived at the receptionist window. They also explained that there would be a delay today with their wait because they did not have enough available examination rooms. The waiting room was full. The patients were then weighed and vitals were taken and then they were asked to take a seat back in the waiting room. The wait for each patient was about 1 hour before they saw a physician assistant (PA) who did the assessment and then another 20 minutes before the doctor arrived. The PA and the doctor made hand notes inside the record. The physician signed off in his own handwriting. The patients were typically out of the clinic within 2 hours. In the time between when the patient was in the examination room and the doctor arriving, a person entered and introduced herself and then asks the patient and family if she could ask them about their visit so far. The person wanted to know how they ranked in service and what they could do to improve. They even asked the family members for comments. I noticed that people were smiling and everyone seemed genuinely happy to work there. Service was defiantly a priority with them.

Here is what I observed at clinic B. The waiting room was packed. When a patient went to the window to note their arrival they were treated in an assembly line fashion. I did not notice any smiling of the staff behind the glass plated receptionist window. The wait was typically long for each patient. One patient went up after an hour of waiting and asked the receptionist how much longer. She was told that it would be another hour before she would be x-rayed then she would be assigned to a room. She was told that she had two people ahead of her. There was a sign next to the receptionist windows that stated after 30 minutes and if your name is not called, please notify the receptionist. The patient was finally taken to the x-ray room after another hour of waiting. She was treated respectfully by the staff but there was some joking going on about the need for her to call her husband to request that he make dinner because of the long wait. The patient then went back to the waiting room where she waited another 3 hours along with everyone else. Most patients that I noticed continued to wait. The patient was placed in a waiting room where she was asked if she would like a soda. The staff explained that the doctor had broken a leg and was on crutches. The patient was told that she would eventually be moved to a closer room for the doctor when one came available. The patient was finally seen by the doctor without any apologizes from the doctor about the waiting. The doctor made hand written notes in the record after reviewing the x-rays. The handwriting was very hard to read. When the patient asked the doctor about the long wait, the doctor blamed on the x-ray. The patient told the doctor that she sat in the examination room for over an hour after the x-ray. The doctor then blamed it on the broken leg and not having a PA. Total time spent at the clinic was 5 and half hours.

It is notable to mention that both of these practices still have some workflow processes to deal with. Both clinics have room for improvement.

How can the electronic health record be used as a service tool?
• By using it as a time management tool (Speed up receptionist process)
• Over all workflow process tool
• Communication tool among staff (no more sticky notes)
• By using specialized templates to expedite the charting process for clinicians
• Eliminate transcription services and still have legible documentation
• By bridging the gap among health care providers. (interconnectivity)
• For feedback to patient on medications (information on medication)
• E-prescribing
• Sending out automatic patient satisfaction questionnaires for follow-up

This is just a small list but if you would like to know more about how to make your practice or hospital more efficient please send us an email.

Tags: consultant, EHR, health care industry, health care provider, hospital, Physician practice, Project Management, service, tool