The electronic health record (EHR) has profoundly changed the practice of medicine and is perceived as both a blessing and a burden by clinicians who use it. Regardless of whether using modern-day EHR systems was part of their medical training, most physicians struggle to keep up with the daily demands of their EHR, let alone manage to find the time and bandwidth to master it.

Furthermore, the near-universal adoption of virtual care and telehealth during the COVID-19 pandemic has increased patient expectations and awareness about EHR-based communication tools, resulting in increased physician time spent on the EHR.

Meanwhile, the EHR has evolved dramatically, in both positive and negative ways. While most EHRs now have customizable tools that, if used optimally, can save physicians time, there are also many more unnecessary “clicks” and automated messages clogging up inboxes. The EHR burden is a major contributor to physician burnout, and it has become a problem that individual physicians cannot fix on their own. It is imperative for organizations to learn how to “tame” the EHR by implementing effective team-based care principles and responding to feedback for continuous system-level improvement.

The EHR problem can be thought of as encompassing a few “buckets”:

• The volume of unnecessary work that is being done (eg, extra clicks and unnecessary mental bandwidth spent on filtering signal from noise, patient questions and requests that could have been avoided with better teamwork and workflow re-engineering)
• The volume of necessary work that needs to be done (but can be shared by nonphysician team members) (eg, chart review, order entry, documentation, inbox management).
• The technology itself

This playbook will focus on addressing each of these buckets so that individual clinicians and their practices can:

1. Minimize the unnecessary work by deimplementing unnecessary rules and looking upstream to stop unnecessary message, notifications, and results from entering the inbox
2. Manage the necessary work by utilizing team-based care principles to offload inbox management, order entry, and documentation from physicians alone
3. Become more personally proficient at using EHR technology

This Taming the EHR Playbook is for:

• Daily EHR users (eg, physicians, physician assistants, nurse practitioners, nurses, medical assistants)
• Organizational leaders (eg, Chief Medical Information Officers [CMIOs] and Chief Compliance Officers [CCOs])
• Medical directors
• Practice managers
• Operations leaders