The grumbling over EHRs in the physician community is getting noticeably louder. A survey of more than 400 physicians by the American College of Physicians found that  using EHRs added an average of 48 minutes to each physician’s work day. The American Medical Association, meanwhile, released a framework that outlined  eight ways to improve EHR systems for doctors.

Rather than seeing these developments as negative, I consider them positive for two reasons. First, they show that doctors have moved beyond the paper versus electronic medical record stage. They know electronic is here to stay, and there’s no going back to paper. Second, they show that doctors want to be active participants in designing the next generation of EHRs for providers and patients. That can only benefit all stakeholders along the health care delivery chain.

Nowhere is their input needed more than in optimizing EHR systems for quality measurement and reporting. The pressure to optimize comes from a variety of internal and external sources. Internally, everyone wants to do right by patients. Everyone wants to improve the quality and safety of patient care. If EHRs help them achieve those goals, they, in turn, want their EHRs to do the best job possible. Internal pressure also comes from provider competition and health care consumerism. With so much public reporting of performance and performance transparency, everyone wants their numbers to be accurate and credible. External pressure comes from the shift from fee-for-service reimbursement to reimbursement based on value or performance. That shift makes a health IT system’s ability to collect, analyze and report quality and safety metrics crucial to an organization’s financial health.

Regardless of whatever internal and external pressures exist, an IT system only knows what you tell it and what you asked it, and those are the keys to optimizing systems for quality measurement and reporting. Provider organizations must configure their IT systems to make it incredibly easy for doctors, nurses and other clinicians to input clinical information and then make it incredibly easy for doctors, nurses and other clinicians to extract the clinical information they need to make medical treatment decisions. Here are 10 criteria for systems and upgrades that provider organizations should consider in their effort to make those twin goals a reality:

  1. Natural language processing that recognizes and sorts audio or voice notes by key phrases and words, avoiding the need to do it manually through transcription
  2. High ratings from clinicians in terms of usability. In other words, the system or upgrade should be intuitive and easy to navigate.
  3. Ease of entering and finding clinical information. Does the system have the right boxes? Does it have the boxes in the right order? Is it easy to put information into the boxes? Is it easy to find the information in the box?
  4. Ability to input patient data offsite, 24/7 from external sources such as smartphones or tablets.
  5. Access to patient data 24/7 using external sources such as smartphones or tablets.
  6. Ability to exchange data with systems used by other providers in order to capture all clinical performance data that could affect medical treatment decisions and, ultimately, clinical outcomes.
  7. Enhancements to clinician workflow that improve rather than hinder efficiency.
  8. Initial and ongoing training for clinicians on how to optimize the system’s ability to collect, analyze and report clinical performance data and how to use the system efficiently and effectively.
  9. Automatic configuration of clinical performance data for mandated government reporting requirements and for public reporting purposes.
  10. Feedback that demonstrates the value to clinicians of using the system to improve the quality and safety of patient care.

The most important thing to remember about optimizing your health IT system for quality measurement and reporting is that it’s all about the people, how they’re using it and how you want them to use it. Your specific technology must be able to satisfy all three requirements with patients being the ultimate beneficiaries of the high-quality, safe care that is the result of your effort.

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About the author

Michael Blackman, M.D., is chief medical officer at McKesson.

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