Physicians at Emory Healthcare removed up to one-third of clicks from their ambulatory workflow and, on average, are spending 36 percent less time finishing charts from home.
Emory Healthcare builds 37 specialty workflows, increasing solution adoption and reducing the time physicians spend navigating patient charts.
Physicians at Emory Healthcare, based in Atlanta, GA, removed up to one-third of clicks from their ambulatory workflow and, on average, are spending 36 percent less time finishing charts from home.
The recently documented successes come from a physician optimization project implemented across more than 80 outpatient locations and four acute care hospitals. Emory began the project to combat the expected increase in physician workload from the transition to ICD-10 and to mitigate increasing physician frustration from navigating electronic health records (EHR) not optimized for individual workflows.
“We knew that coding in ICD-10 would take longer, and we were looking for ways to leverage IT to make workflows more efficient,” said Dr. Julie Hollberg, chief medical information officer, Emory Healthcare. “Duplicative work, system slowness and the lack of specialty views within the electronic health record were also taking away time with patients.”
As part of the project, Emory and Cerner recorded four of Emory’s most EHR-proficient physicians and counted the number of clicks in their current workflows. Cerner mapped this to the workflows enabled by the new tools, observing an average reduction of 36 clicks.
Emory leadership kicked off the project with a “communications tour” where they spoke with all 37 department clinical and operational leaders. The tour focused on the benefits each specialty would receive, including the metrics they planned to track.
“Showing data that illustrates the potential time-saving improvements built credibility with our physicians, and helped us increase operational engagement” said Hollberg. “In order to have a successful IT implementation, you have to partner people, process and technology.”
To better capture the patient’s story, Emory implemented Cerner’s Dynamic Documentation solution. This semi-structured customizable documentation tool provides physicians with a more attractive and readable format.
“Dynamic Documentation plus Dragon voice recognition software enabled physicians and nurse practitioners to get back to telling the patient story,” said Hollberg.
Emory leaders also worked closely with their Cerner team to identify and track specific metrics to assess success and identify opportunities for improvement. Of the 36 metrics Cerner offered, Emory chose nine and added one of its own: Pajama Time, which is a physician’s time spent in the EHR from 6 p.m. to 6 a.m., Monday to Friday, plus weekend time.
“Cerner was an essential and wonderful partner in this project,” said Hollberg. “They provided a ton of technical resources and helped fill gaps whenever we had them so that we could meet our deadlines.”
Eight weeks after implementation, clicks dropped and Pajama Time decreased. Emory leadership was also seeing strong adoption: 71 percent of physicians adopted the new documentation tool, order entry increased 74 percent and transcription usage decreased 29 percent.
“It is much, much better,” said Hollberg. “The customized views have improved and facilitated specialized workflows; the new documentation tools are cleaner and easier to use. We have less frustration, more efficiency and greater satisfaction.”
Emory’s leaders consider the recent achievements wave one of a long-term project. Next, they will revisit any individual physician requests that weren’t addressed in the first phase.
“We’re never done,” said Hollberg. "This is good, but we still have a long way to go to optimize the provider experience and meet our end goal of optimizing our patients’ experience.”