For many organizations, the relationship between users and their electronic health record (EHR) often wavers. System expectations are generally high likely due to cost. Clients, however, often end up with a system they are only semi-happy with. To maintain a good balance, it’s important to understand baseline workflows, change leadership, and how to properly leverage new technology to drive revenue cycle performance from an EHR.
Solid workflows help eliminate bottlenecks, streamline redundant tasks and prevent miscommunication. It is easy to assume new EHR systems are going to fix or correct broken legacy workflows. However, it is the incorrect workflows that often mottle the EHR install. As performance improvement (PI) initiatives are underway, workflows should be mapped, reviewed, and supported by each of the owning areas.
Before attempting to enhance the current workflow, the baseline workflow should be sound. Start by designing the workflow on a flowchart or through a Microsoft Visio diagram. Providing visual structure to the workflow can help those who are not able to visualize the process in writing. From there, look to eliminate the bottlenecks and stream tasks through people and technology.
It is also important to determine how you are currently measuring the throughput of the process. Without key analytics, measuring the success of an enhancement can be difficult. In the end, workflows that are structured correctly provide users a sense of control. Their decisions give them the authority to take the correct action; otherwise, broken processes will make users weary of future changes.
PI initiatives are certainly complex, involving both technical and nontechnical components. The technical component, the EHR itself, is dynamic. There are an infinite number of modifications that can be selected. However, it is users, the nontechnical component, who dictate our ability to outperform current key performance indicators (KPIs).
As system improvements take place, user roles and responsibilities change. Their familiarity with legacy workflows soon become obsolete. So, users either change their behavior and adapt or become increasingly frustrated as processes are enhanced. Therefore, change leaders must champion change.
The role of a change leader during PI initiatives is active and demanding. It is their responsibility to produce group consensus as they are navigating user skepticism. Change leaders can improve user acceptance by understanding the EHR technology and leveraging their background knowledge of the current workflow being modified. A strong change leader will have the ability to assess whether the usage of technology integrates with users and their processes.
Challenge the Technology
EHR technology is ever changing. System designers develop EHRs with a specific set of workflows and intentional functionalities in mind. When possible, challenge the information technology (IT) team’s ability to innovate. Avoid using out-of-the-box solutioning.
Why? Organizations engaging in PI initiatives often select the quick, least-expensive EHR installment method. Typically, this leads to the EHR dictating or overcomplicating legacy workflows. So, as workflows are being modified or enhanced, ask questions! Often, the simplest functionality can offer the most advanced solutioning.
It is easy to forget how complex EHR technology can be. When presented with so many new bells and whistles, organizations may find it easy to accept everything. To ensure your organization is getting the most from its technology, leverage partnerships with consulting firms. Many are well-versed in the technology and they can help drive the performance you are expecting by integrating the technology into your current workflows and connecting end users.
Where to Start
Start by refining effective communication workflows. In general, communication workflows are often overlooked or underdeveloped during the initial installment. Simply converting from paper to EHR communication is great, but what about taking electronic communication a step further? Instead of sending unsolicited emails, scheduling spontaneous meetings, or making arbitrary phone calls, allow the EHR to drive the work.
For example, manually routing or triggering processes in the legacy workflow can generally be designed in the EHR. Here are several examples of communication workflows that enhanced during PI:
- Prioritizing surgery or patient add-ons within 24-72 hours
- Sending patients notifications through portals for missing information
- Routing claim errors to the owning department
- Automatically requesting medical records from release of information
- Directing denials to the appropriate owning area
Even with proper planning and attention to detail, it is inevitable a process will not function as expected. But strong communication between departments is key to navigating rough water. Consider partnering with a firm that understands the importance of communication with an HER – they can help navigate and provide guidance where breakdowns may occur.