I was talking to a leader in a well-known pediatric facility in the south west the other day and they had mentioned that they had identified a few hundred separate opportunities for optimization and they planned to rank these to understand the order in which they focus their resources, time and energy over the next several months. Several thousand hours of work effort can be the timeframe for such initiatives and this occurs when clinical workflow follows the EMR versus the other way round.
As organizations are now facing the prospect of having to improve the efficiency of their EMR workflow, their initiatives to optimize across their clinical settings become more imperative. Improving the workflow of the physicians and clinicians that use the EMR for patient care needs to occur if the full potential of these very expensive systems implementations can be realized. After attesting for meaningful use for and receiving payment from CMS many early adopter organizations put in a great deal of work effort to quickly install, train and begin to using their EMR system so that their physicians would see some return from the efforts. Not all of the deployments of EMRs can as closely match the pre-EMR implementation workflow and exact documentation prior to go live of the system.
These initiatives are reminiscent of the post ERP implementation days right after Y2K when many organizations had implemented their ERP systems without taking into account their own internal processes and they focused on implementing the software without a thought for post implementation support. Other projects such as EMR upgrades, break fix, meaningful use and we continue to deal with ICD-10 would hinder the work of the resources as getting them to focus on a particular project when 4 to 5 others are still on the docket, is incredibly difficult.
While realizing that many physicians (at least mostly more experienced ones) are not as excited about using their EMR, they will be the ones that will ask if they can get their patient care completed with “fewer clicks”. Working with your EMR vendor to understand best practices that they have had the opportunity to work on, being able to focus on enhancing particular areas that your current post implementation functionality does not yet support and possibly sun setting some systems as their day has arrived due to their technology being obsolete or to expensive to maintain.
Focus on “Defining” what your optimization objective needs to be and make sure that you create a governance structure as your optimization initiative must be able to be reviewed by a governing body of IT, physician champions and operational leaders that aligns your optimization initiative with your organization’s mission and goals and the decision making for the initiative is clear and efficient. Make sure that your Project Charter clearly sets forth your optimization goals. “Measuring” what process you want to improve needs to be completed. For instance, if it is truly reducing the number of clicks that a physician has to go through, then understand what their current process is and record the data for how they perform patient care currently.
Analyzing the data to understand what makes the process defective and then discuss with the clinician what they think could be a better workflow. Work with the vendor to see if their suggestions can be incorporated to “Improving” the process and after “go live” of the new process, make sure that the sign off by the physician/clinician has occurred and “Control” the environment so that the new process can take effect smoothly.
Getting your optimization initiative done right will pave the way for qualitative and quantitative rewards for your organization. In the world of increased patient engagement and “digital native-ness” of the patient population, having a thoughtful clinical optimization strategy will give your provider organization the efficiencies it needs to compete in a faster paced healthcare ecosystem.