EHR Burden: What is it and is there anything being done about it?
EHR’s or Electronic Health Records are the system we use to record important patient data electronically. Originally, the benefit was to reduce paper waste, prevent from records being lost, and be able to analyze data quickly. Though it has come a substantial way in features and overall technology, EHR’s have also developed some flaws.
Most nurses would argue that EHR’s have become more of a burden than a help.
So what is EHR Burden?
Simply, it’s the extra time it takes in the day to record everything that we do and all the extra clicks and typing it takes to get there. EHR burden is where the phrase “I get paid to click buttons” was coined. Ed Corbett, MD from Healthcatalyst.com identifies five common burdens of EHR’s.
His examples include:
1. Reduced quality of patient interaction
2. Longer work times
3. Poor design
4. Outrageous quality measures
5. Outrageous cost and maintenance
Though the fifth one, cost and maintenance might not affect nurses directly, it could indirectly affect their pay due to the cost to the company.
What can be affected by the EHR Burden?
How can you determine if you have suffered from EHR Burden? If you can relate to any of these questions, you have experienced the burden of EHR’s
Lack of Patient Care
How many times have you not done an important patient care activity because you still hadn’t charted the last 5 hours of things you did?
Longer Hours
How many times have you stayed at least an hour late catching up on documentation?
QA Citations
How many times has your unit been cited by quality assurance for missing “important documentation features” for billing or federal measures? My guess would be too many to count!
How is the EHR Burden Being Handled?
Lucky for nurses, the burden of EHR’s is becoming more voiced. So much so that the Department of Health and Human Services (HHS) released a report that addresses the EHR burden.
HHS identifies three goals:
These goals seem reasonable to be both an improvement for nurses and patient care alike.
- Reduce the effort and time to record data while seeing patients
- Reduce effort and time meet requirements set by governing bodies
- Improve functionality and ease of use
Key Areas of focus: For each goal, the HHS identifies four key areas that need focus.
- Clinical Documentation
- Ease Usability
- Federal EHR reporting requirements
- Public Health Reporting (Including Controlled Substances)
Requirements: Each initiative must meet three requirements.
- Achievable in about 3-5 years
- Implemented through existing or easily expanded authority
- Include actions that improve patient care and overall experience for clinical documentation
The Strategy behind the Key Areas:
Each of the key areas are then designated three to four strategies, which are then broken down into additional recommendations.
Take key area number two, Ease of Usability
One of the four strategies given for this area is to:
“promote harmonization surrounding clinical content contained in health IT to reduce burden”.
The strategy is broken down into three recommendations that include:
1. Standardizing medication information
2. Order entry content
3. Promoting best practicing and user interface design frameworks for results displayed within health IT.
SMART Goal Assessment
Goals must be specific, measurable, attainable, relevant and time-bound. These are the basics that we all learned about in school. As we go through the HHS process, we can start to identify some inconsistencies between what we practice every day with SMART goals and how the HHS is handling the EHR Burden.
Each Goal has a Key Focus, which has the Requirements, which has the Strategies and so on, and so forth. This hierarchy of goal setting is broken down in that exact same way. This goal setting is specific enough to know where the targets are in the system, but it is lacking the qualities of a “SMART” goals.
In this report, the goals are missing two of these aspects “specific” and “measurable”. The report doesn’t delve into HOW they are going to standardize medication information or HOW they will measure that it has succeeded. But ultimately, whether they are SMART goals or not isn’t the question.
Ultimately is there anything being done to reduce EHR burden and is it helping or hurting nurses?
The answer, though it might be different from everyone, is two-sided.
Is there anything being done to reduce EHR burden? Yes.
But is it helping or hurting? That is left to be said.
There is a plan in place, but until there are actual changes that make it to the frontlines, it would be hard to argue that there is any help. And of course, if there is no help, there is hurt.
Hopefully, some of these strategies get put into place soon because some nurses are really feeling the burden.
What about you? Are you feeling the burden? What do you think should be done to reduce EHR burden?
0 Comments