Journal of Healthcare Management - March/April 2014 - (Page 145)

use of eHr d ocu Mentation By H ealtHcare w orkers PRAC TITIONER in a H ospital s ysteM A P P L I C AT I ON Gene Shaw, FACHE, CPHIMS, FCHIME, chief information officer, Yuma Regional Medical Center, Yuma, Arizona T he implementation of electronic health records (EHRs) has risen to the top of the strategic priority agenda for many healthcare organizations throughout the United States. Several factors drive this agenda, but most healthcare leaders would describe a focus on patient safety, the elimination of redundant information, and a drive for efficiency as among the top considerations. The authors' timely research takes the discussion to a new level through the examination of clinicians' use of the data entered into the EHR and the perception of time spent reviewing and documenting within the system. It is exciting to see the discussion move to this level. The drive to purchase and implement very complex technology systems brings the industry to the starting line. The next essential discussion, as suggested through the authors' research, is how we use the data to improve the health of those we serve. Efficient use of the EHR can be improved by ensuring that those who work with the system-end-user clinicians-are represented within the governance structures that guide change management decisions and improved functionality. We can gain valuable insight regarding confusing workflows, unnecessary flow sheets, and redundant data entry points with these individuals at the decision-making table. Focused tracer audits and rounding discussions on clinical units should also be conducted to document the voice of the end user and provide essential input into clinical system governance priorities. An essential link between the information technology (IT) professional who works to build or enhance the EHR and the clinical end user is the "super user." This individual, who is part of the clinical team, serves as a conduit between clinicians using the system and the information technology analyst. The clinical super user provides valuable input to the IT analyst as workflows are redesigned or clinical flow sheets are enhanced. Super users working side by side with clinical colleagues can provide just-in-time education, tips and tricks, and real-time troubleshooting. New forms and redesigned processes brought about through an integrated governance model are addressed by the clinical super user at the bedside through informal training and on-the-spot clarifications. The authors' research identifies several components documented in the EHR that are used most often in the care of patients; one of these is the Vital Signs portion. The collaboration of clinical users, IT staff, and biomedical engineering personnel can ease this documentation burden through the integration of physiological monitoring equipment into the EHR. Significant time savings for clinicians can be gained 145

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2014

Journal of Healthcare Management - March/April 2014
Contents
Interview With Marna P. Borgstrom, FACHE, President and Chief Executive Officer, Yale New Haven Health System, and Chief Executive Officer, Yale-New Haven Hospital, Connecticut
Specialties: Missing in Our Healthcare Reform Strategies?
Costs and Benefits of Transforming Primary Care Practices: A Qualitative Study of North Carolina’s Improving Performance in Practice
Governing Board, C-suite, and Clinical Management Perceptions of Quality and Safety Structures, Processes, and Priorities in U.S. Hospitals
Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System
Why Hospital Improvement Efforts Fail: A View From the Front Line

Journal of Healthcare Management - March/April 2014