Digital Rounding

Rounding IT Support Improves EMR Usability

    

I’ve enjoyed evaluating the EHR IT support processes used by several high performing healthcare provider organizations. What is most interesting is the reallocation of IT support resources from their desks to proactive rounding supporters to assist providers in optimizing their EHR.

In this new paradigm the support staff round through the clinical care environments to identify clinicians who may be having trouble operating the EHR to meet their needs. When rounding, the IT support people can also be hailed by clinicians who need immediate assistance. We’re starting to see digital rounding tools emerge to help clinicians provide better patient care on their rounds, why not add tech-support rounding to help your IT team provide better clinician care?

Another variation of this evolving support model has the rounding IT support personnel visit the outpatient and community environments of the health system. These visits are especially effective to provide follow-up education for clinicians who had initial training within the last 30, 60, or 90 days. The success of these rounding IT support services is validated by the number of requests received from the clinicians to get the IT support staff to round at their outpatient and community facilities.

Rounding IT support services are also effective in helping clinicians better adopt new EHR capabilities delivered via EHR upgrades. Often, the traditional emailed tip sheets don’t work well for educating clinicians on upgraded EHR capabilities.

For clinicians struggling with the EHR, alert fatigue and an overloaded patient schedule makes answering email feel more like triage and less like communication. Structured training on EHR upgrades may be effective, but in many cases don’t accommodate the schedules of the clinicians. Take the training and support to them!

Does this mean the traditional help desk is eliminated? Not necessarily, but the help desk in a rounding IT support environment is best positioned as an emergency-fix support service to resolve critical EHR performance issues.

By eliminating the help desk as the locus for clinician support and service requests, you remove a primary source of clinician frustration. Traditionally, when a clinician contacts the support desk (hopefully when they are not treating a patient) several things may happen, and most are not ideal.

First, the clinician may not be able to connect with the help desk: frustration #1. Then the clinician is given a ticket or a number that identifies their request. A timeframe for resolution may not be given or may be longer than is acceptable to the clinician: frustration #2. Finally, the clinician may have forgotten about this request until they are notified of a resolution or non-resolution of the issue weeks or months later: frustration #3. By getting the IT support staff out and rounding, you remove the “hurry up and wait” atmosphere of traditional support models.

What are the challenges with converting traditional IT support from mainly help desk services to a proactive rounding service?

The first, and possibly the most difficult: assessing the current IT support staff to determine if they have the teaching and interpersonal skills to effectively engage and work with the clinicians in at-the-elbow, patient care environments. The second hurdle to overcome will be determining if the required staff needs a skill level that demands a higher pay, and how many of these people will be required to meet demand. This will likely result in the need to create and defend an increase to the EHR IT support budget for one possibly much higher than your current help desk model requires.

At this point, I think we’ve lost the CFOs in the room. However, well trained and efficient clinicians should deliver higher quality care and patient satisfaction. Additionally, how much does it cost to recruit and train a new clinician after one leaves because they are exasperated by an outdated EHR support model that drives high levels of frustration?

While we may not have understood when Meaningful Use first came into being, digital healthcare means blending the clinical with the technical. As we’ve seen within the Arch Collaborative, innovative models such as IT support rounding contribute to successful EHR experiences. It is time for healthcare organizations to adopt rounding IT support services for their EHR environments.