RAHIL KRISHANA, MD | NOVEMBER 3, 2018
At go-live, the goal of every Electronic Health Record (EHR) firm or consultant should be to make the provider feel as comfortable with the software as possible. Ultimately, comfort translates directly into charting efficiency, an improved patient experience, and patient safety.
For me, helping physicians thrive, not just survive while using their EHR is the goal. It brings me great joy to effectively relay my EHR knowledge (accumulated through grueling years of training and using an EHR) to the provider and have this incorporated into their daily workflows. I like to think the providers I assist benefit from my years of trial and error, gaining years of EHR knowledge in just a few days with the effective specialists-training-specialists (STS) model.
The providers we assist have a broad spectrum of EHR and technology exposure and aptitude. One of the most challenging and rewarding scenarios we encounter is the near-retirement provider who is not tech savvy and resisted even acknowledging the EHR conversion.
Fitting this mold is a 69-year psychiatrist I recently assisted. Being forced to learn and use Epic made retirement a more viable option by the day. On top of an already demanding job he had to face the anxiety of learning a brand-new system and re-inventing his workflows. Fortunately, his hospital adopted the STS model for training and go-live support. We built an instant rapport over our shared medicine background and started to tackle his anxieties one-by-one. Our first task was surviving morning rounds. Each day we made incremental improvements to his rounding workflow. By the end of the go-live support time frame his information gathering, note writing, and order placing workflows were seamless. Most rewarding, and something that will stay with me forever were his words on my last day, “I could not have done this without you.”
Doctors, just like this psychiatrist, are being forced (for better or worse) to reinvent their practice of medicine. Everyday hospital systems and clinics are converting to EHR’s, changing vendors, and undergoing software upgrades. Although it seems like progress, many do not realize the energy and toll it takes on practitioners to change how they approach and provide patient care. The added stress, anxiety, and demand has led many physicians around the country into early retirement. A scary phenomenon as the US is facing a potential physician shortage. Just read Spitzer’s story in the Daily Herald about the 75-year-old obstetrician at Hoffman Estates, Ill.-based St. Alexius Medical Center who delivered tens of thousands of babies is hanging up his hospital coat after refusing to take classes and learn the hospital’s new computer system.
I believe that hospitals need to leverage and engage the STS model early in their EHR conversion to de-escalate physicians confronting these cataclysmic changes. Having the right personnel to expedite physicians EHR efficiency is paramount and reduces a mountainous learning curve to just a small speed bump on the road to success.
I have seen the STS model save careers. I can only imagine that the downstream of its ripple effect through healthcare is even larger than I could imagine.
JOSEPH LEE | APRIL 9, 2018
University of Chicago Medical Center
Department of Pediatrics, PGY-3
As a trainee, I find myself pondering what life will be like when I am an attending. How will I be treated by residents, nurses and other members of the medical team? And in turn, how will I treat those that I am commissioned to lead? My experience working in the Neonatal Intensive Care Unit (NICU) as a MedDocLive (MDL) consultant through the EPIC Go Live process has provided me a glimpse of both.
Electronic medical records (EMRs) have provided both immense progresses in communication within the medical system as well as burdensome requirements for providers. In fact, some providers state that the creation and implementation of EMRs have single handedly decreased their satisfaction with the profession. With that said, it is safe to say that switching EMRs creates an atmosphere of both excitement and apprehension. That is where we, as MDL consultants, enter the scene. It in such an environment, we are commissioned to work and support providers in the transition. Further, it is in this role that I had my first taste of the type of supervising doctor I will be.
As a senior resident, I am accustomed to leading rounds as a medical provider. Further, I can be confident in my plan knowing that my attending will correct any discrepancies. As an MDL consultant, I round with the same teams, however this time, I am the last line of decision making and trouble shooting. And while the issues pertain to EPIC, the current medical record keeping climate establishes EPIC as the final decision maker as to what labs are drawn, what images are taken, and what medications are given. Thus, I serve as the gate keeper between patient illness and patient health.
From going through each order of an admission order set to pulling up chest x rays, I have sat and stood with providers in each step of the process of learning how to utilize EPIC. At times, there was joy and adulation, and others, there was stress and anger. In some cases, I have been able to solve the problem, in others I have had to admit defeat and use my resources to try and triage the problem. In both scenarios, however, I have waited and worked patiently with providers, being decisive when I have had to and taking a step back when that was in the best interest of their learning process. And through it all, I am reassured that my future as a supervising doctor is bright. I will maintain my passion for patient care, my compassion for others, and respect for all people.
I never thought that serving as an MDL provider through the EPIC Go Live process would have taught me so much about myself and my leadership abilities. Through every road bump that the providers and I have been able to hurdle together, I have learned that I can and will be a supervising doctor that is patient and kind. So I rest assured that as I continue on this arduous journey called residency, the hours and stress have not changed my core values. And for that, the patients I will serve and the medical team members I will lead will be forever grateful.