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Strategies for Optimizing the EHR System

Galen M. Metz, FLMI, AIAA, AIM, ACS

Posted by Galen M. Metz, FLMI, AIAA, AIM, ACS
June 29, 2017

An EHR is often installed quickly, to earn incentive payments or to save on implementation costs.  But by doing so, the associated workflow processes may not be optimized for your organization. For example, the system may enable patients to email their physician, but this may result in a flood of such emails. An optimization effort may introduce a triage step where nursing staff or a care team help categorize the email. Which email must the physician address immediately? Which can wait, or be handled by others?

According to a May 16, 2017, article, “a recent survey conducted by HIMSS Analytics showed 68% of the healthcare leaders who responded plan to adopt new technologies and tools to improve the use of EHRs and ease clinician burnout.” 

Here are some strategies to help make optimization efforts, the third step in the EHR Continuum, successful.

1. Identify pain points in your current process.

This may be as simple as interviewing the staff, conducting surveys, or listening to focus groups. Find out where inefficiencies are hampering service to the patient. Do not wait for this situation to fester and affect morale.

Listen to your staff..jpeg

 2. Be open to change. 

Watch out for the “we have always done it that way” response. The EHR opens the door to new possibilities, possibilities that may not have been possible in a paper-and-pencil world. Be willing to reevaluate your processes and consider ways to make them better.

3. Take a systemic view. 

Start by examining the entire end-to-end process. There are numerous tools and methods to do this. I personally like the simplicity of using flowcharts to diagram the workflow. 

Workflow Diagram.jpegLook for bottlenecks, extra steps with limited value, and cumbersome handoffs. Avoid suboptimization, making things efficient for one department, but at the expense of the overall flow for the organization.

4. Learn from others. 

Attend user groups to learn from the issues and experiences of other customers. They may have years of additional experience with optimization. Learn from them. What has the vendor seen in their numerous implementations?

5. Assess upgrade features. 

Examine new features introduced in the latest EHR upgrade. These may include new creative optimization methods, in response to issues raised by customers. Evaluate if the features make sense for your organization and its workflows.


6. Explain why the change is being made. 

I’ve found that the willingness to accept a change goes up in proportion to the amount of information provided. A willingness to accept change can be tied to the big picture, why this change is better for the patient and the organization.


7. Allocate time and staff. 

I am reminded of the old story of the woodcutter who is too busy sawing to take time to sharpen his saw. Optimization can take time, but is worth the investment. And, like the EHR itself, optimization is an ongoing process, continuously improving the system and workflow processes, not a one-and-done effort. Allocate staff to these optimization strategies to make your EHR and workflows the best they can be for your organization.  Or are you too busy sawing?

Wasting time with a dull saw..jpeg


Read The Holistic CIO by 

GALEN M. METZ, FLMI, AIAA, AIM, ACS for the next chapter, "The Promise of Data Analytics."

CIO Graphic - Analytics.jpg

The Holistic CIO by Galen M. Metz, FLMI, AIAA, AIM, ACS
Galen M. Metz, FLMI, AIAA, AIM, ACS

Galen M. Metz, FLMI, AIAA, AIM, ACS

Galen is author of • Secrets of Healthcare IT Revealed ( • If You Give a Mouse an EHR – A Parody ( • The Holistic CIO ( He retired after 30 years of healthcare IT management. Previously Galen served as CIO of Group Health Cooperative in Madison, Wisconsin, with responsibilities for the electronic medical record system, health insurance system, self-service web and mobile solutions, business intelligence, and technology infrastructure. Galen is also a professional magician, specializing in close-up magic. The relationship between technology and magic was observed by Arthur C. Clarke, who wrote, “Any sufficiently advanced technology is indistinguishable from magic“.

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