4 quick-win changes in the EHR free up hours weekly for doctors

Tanya Albert Henry , Contributing News Writer

As health systems add chief wellness officers (CWOs) to their teams to focus on making changes to improve the systems that put unnecessary strain on physicians and other health professionals, most of the work won’t involve quick fixes.

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During the AMA STEPS Forward™ podcast “Improve Practice Efficiency with EHR ‘Quick Wins,’” Marie Brown, MD, a Chicago internist and the AMA’s director of practice redesign, spoke with guest Nigel Girgrah, MD, PhD, the CWO at Ochsner Health in Jefferson, Louisiana, about four “quick win” changes health systems can make to improve practice efficiency and reduce physician frustration. Listen to the podcast on Spotify or Apple Podcasts.

“This is time that they can spend away from a computer. Time they can either spend directly interacting with patients or time they can spend with their families or loved ones,” Dr. Girgrah said.

There is not one intervention that can magically change everything. But some easy changes will add up to hours of saved time for busy physicians. Dr. Girgrah said one person told him EHR duties can be like death by 1,000 cuts. So, making some of these “quick win” changes is like “removing each of those cuts systematically, or removing as many as you can,” he said.

Here are four ways practices can help physicians gain back valuable time.

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For busy physicians and other practitioners, logging in and out of the computer can be a lot of work and those keystrokes add up.

Work with your EHR vendor to create a way for physicians and other practitioners to tap their badge to log in to the system.

Time saved per day for busy physicians? About 20 to 30 minutes.

When physicians order tests such as a CT scan or MRI, questions pop up in the EHR that require doctors about 20 clicks to get through. For about half of those questions, though, the EHR already has the answer, Dr. Girgrah said.

His team worked with the IT department to tweak the EHR so that physicians didn’t have to answer questions that were already in the EHR, saving them time with each order.

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Ochsner, a member of the AMA Health System Program, introduced Epic in 2012. About nine years later, there were 18 million unread messages in the in-baskets.

Knowing there were so many unread messages provided “an opportunity to look at unnecessary or duplicative message types and actually remove them going forward,” Dr. Girgrah said. For example, primary care physicians were getting an email when a patient checked into the emergency department, when they were seen and then the disposition.

“I guess that’s nice, but what you hear from our primary care physicians is they basically just want one message that summarizes all of those events,” Dr. Girgrah said.

Cutting down on the number of messages generated was a win for physicians in time saved and patient safety, he said.

What started as a quality and safety initiative by the pharmacy team turned into a physician well-being initiative that eliminated about 70% of the pharmacy refill requests that doctors and their teams were receiving.

Ochsner gave pharmacists access to medication specialists who could handle refill questions, allowing everyone to practice at the top of their license. The health system also began using a third-party vendor to extract patient data points to help determine if it was safe to refill a prescription.

Depending on how busy a physician was, the change saved 25 to 40 minutes each day, Dr. Girgrah said.

Another way to shave the amount of time physicians spend in the EHR: For medications where it is allowed, write prescriptions that cover one year of the medication and synchronize those annual prescriptions for patients with chronic conditions.

To learn more, check out the related AMA STEPS Forward “Saving Time Playbook.”

The AMA STEPS Forward open-access toolkits offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.