After the implementation of an electronic medical record system, an optimization plan is the next key project that should take place in order to address a multitude of issues and to bring the system and its users to a more efficient and advanced state. The concentration of these projects are usually geared towards increasing revenue and/or patient volume as the end goal but what is often overlooked are the provider and patient experiences. By incorporating provider and patient experience with increasing revenue/patient volume as goals for optimization, a positive synergy occurs that will produce happier staff which correlates to better performance and revenue in the clinic.
There are several common things that most clinics struggle with post implementation; unable to get back to patient volume pre-implementation, check-in and wait times for patients are typically much longer than before, unable to close charts timely and efficiently, providers and support staff working long hours and many other issues that contributes to unsatisfactory experience for both the medical staff and patients. In order to identify a thorough assessment of issues, these are some things that should be considered when planning an optimization project:
1.Assess the current state of workflows through shadowing the complete process from check-in to check-out. Shadowing should be done several times throughout the week to accurately capture an overview of workflows in different atmospheres. For example, the clinic may be busier on Mondays than on Fridays so both current states should be documented to understand how staff are being utilized, how long patients wait to see a provider and other useful information that can be revealed by the varying levels of patient volume.
2.Interviews with providers and support staff should be conducted on a 1 to 1 basis to identify trends of issues. Is there enough support staff to assist providers? Are providers pushing work to the support staff? Are there enough workstations in the clinic? Are there issues with locating print jobs? This is important to allow the staff an opportunity to express issues that occur in the clinic without fear of being reprimanded. This will also give the staff a sense that their issues matter and that they are also have a stake in the improvements of processes that affect their daily jobs.
3. Surveys or other forms of metrics for patient experience should be gathered to identify issues. How was the process for registering and scheduling an appointment? Are patients leaving the clinic with meaningful office visit information? Was the communication and follow up with the clinic easy or difficult? These are some of the things that can be used to identify areas of improvement to minimize unnecessary follow up with the practice.
4.In addition to shadowing and conducting interviews, metrics from the system should be used to identify areas of improvement. There are dashboards and reports in the system that can be generated to further reveal issues. Is the build set up correctly that supports both providers and staff? Do they have the necessary tools to carry out their jobs? Are the providers’ orders-tracking and follow up manageable in their In Basket? Do patients have the ability to review their medical information and communicate with the clinic securely?
All of these steps above may seem to be an obvious way to approach optimization but most organizations jump to the conclusion that inefficiencies and the inability to increase revenue and satisfaction scores are solely due to the implementation of a new system since it was a significant and most recent change for the organization. By considering the provider and patient experience as a part of the optimization, this will create a more successful outcome. The people who interact with the system on a daily basis are the providers and patients so it is important that this should be considered and incorporated during an optimization plan.