Payment & Delivery Models

Cutting keystrokes with team approach, EHR tweaks

AMA member Michael Metry, MD, has initiated an EHR update and added two advanced practice providers (APP) and a pharmacist to his rounding team at St. Francis LifePoint Hospital in Columbus, Georgia. These changes created more time with patients and less time on the computer.

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“Any physician, no matter what specialty they are, can make their day more efficient,” said Dr. Metry, an intensivist and director of the ICU at St. Francis. “The key thing is they have to trust the people they work with.

“Everyone has their complaints, [but] you have to create and learn the system,” he added. “You have to put in your resources to make it efficient for you.”

Here are the changes the ICU made to the EHR and team rounding to improve patient care and physician well-being.

Rounding as a team

A crew-resource management system was used for team-based care, which allows for between 18 and 28 patients to be seen during each 12-hour shift. The rounding team consists of two APPs and a pharmacist. One APP will accompany Dr. Metry and the pharmacist on rounds, while the other APP completes various tasks to complete rounding efficiently.

“I do my computer work with my team, but then I sort of push the computer away and donate undivided attention” to patients and families, he said.

Patient-centered rounds allow Dr. Metry to complete his data entry on that visit. By early afternoon, all of his orders are in, and the nurses and family know the plan. This creates time for him to perform procedures, visit new patients, complete updates and catch up with the team.

Templating for fewer clicks

The current system at St. Francis, said Dr. Metry, is “archaic,” but a new system is being implemented in October. To improve care in the meantime, he reached out to the nurse practitioner who also works in IT to create a summary page within the EHR to see all patient information with only one click.

“I click the patient summary tab and—boom—all of my information is right there, so I don’t have to chase around 150 clicks into the system,” said Dr. Metry.  

In one convenient location he can see patient labs, x-rays, current vital signs and medication list. And while it was created for use in the ICU, it can be used by any physician or team in the hospital.

The AMA’s STEPS Forward™ collection offers free online modules that help physicians and system leaders improve well-being, including learning about the organizational changes that lead to physician satisfaction and improving practice efficiency.  All of the modules have free CME and are accredited for MOC Part II.

Several modules have been developed from the generous grant funding of the federal Transforming Clinical Practices Initiative (TCPI), an effort designed to help clinicians achieve large-scale health transformation through TCPI’s Practice Transformation Networks.

The AMA, in collaboration with TCPI, is providing technical assistance and peer-level support by way of STEPS Forward resources to enrolled practices. The AMA is also engaging the national physician community in health care transformation through network projects, change packages, success stories and training modules.