Providing High-Quality Care: The EHR Factors at Play

How Do Clinicians Successfully Leverage Their EHR for High-Quality Care?

While the EHR itself undoubtedly affects clinicians’ perception of its support of care quality, user accountability is actually much more impactful. Many satisfied clinicians attribute their EHR proficiency to their ownership in mastering the EHR. Because they have accepted that the EHR will be part of patient care, they take accountability for their EHR proficiency in pursuit of improving the patient experience. In this case, initiative to learn the EHR improves perception of how well the EHR supports quality care. A smaller (but significant) percentage of clinicians talk about the EHR itself improving care, including a few who say it helps them more easily access patient information and be more efficient, and say that it provides helpful functionality like speech recognition, free-text searches, and HIE data.

What EHR Barriers Hinder High-Quality Care?

Comments from clinicians having a negative EHR experience (i.e., strongly disagree their EHR enables high-quality, safe, patient-centered care) illuminate what they expect from their EHR in terms of enabling high-quality care—and what barriers and gaps they see today.

Dissatisfied clinicians mention many challenges that hinder their ability to deliver high-quality care. Most often, clinicians say the EHR distracts them from interacting with patients. Other EHR shortcomings include inefficiencies, unintuitive user interfaces, occasional downtime, and functionality gaps. For many, this results in a feeling that they are delivering “computer-centered care” rather than patient-centered care. They report that often they spend more time dealing with the EHR and its more frustrating aspects than they do interacting with the patient during a visit.

For some clinicians, quality care means efficiency—and many deem the EHR a roadblock in their efficiency. Charting requirements take up a lot of time and can limit how many patients that clinicians can care for in a day. Others feel that all EHRs are designed primarily for charge capture or billing—not for patient-care workflows—and therefore inherently don’t adequately support high-quality care.

Another common concern is patient safety, typically in the form of documentation errors or poor access to patient information. Clinicians sometimes feel the templated charting functionality in their EHR makes it difficult to either document sufficiently or understand others’ documentation. Others feel that poor access to essential patient information, like medical histories or orders, puts patients at risk. These types of accessibility issues usually result from lack of EHR integration or cumbersome user interfaces. Occasionally, clinicians also cite system downtime as a hindrance to patient safety.

Fortunately, KLAS has found that many of these issues can be combatted with not only strong user accountability but also organizational support. There are many organizations in the Collaborative who have helped their clinicians improve their efficiency, documentation habits, or access to patient information through training, increasing personalization use, or improving their integration. These efforts can be essential in improving providers’ care and keeping patients safe. For more details about these organizational efforts, see the Expanded Insights section.