Don’t throw the baby out with the bath water: Enhancing physician engagement with embedded EHR

As risk-adjusted reimbursement models become more prevalent, healthcare organizations are placing a top priority on EHR-enhancing technologies that make physician documentation more natural while also improving the quality of information coming out of systems. Hospitals are increasing the use of mobile devices and apps, artificial intelligence and other technologies to solve physicians’ needs.
Physician adoption of EHRs – don’t throw the baby out with the bath water

We did it. Healthcare has successfully adopted electronic health records (EHRs). Thanks to multiple government-driven carrots and sticks – and general industry agreement that it was inevitable anyway – most clinicians have transitioned from documenting in paper to digital format.

So why isn’t everyone celebrating?

It’s the big elephant in the room. Industry-wide, there’s a high degree of physician dissatisfaction with EHRs and these very expensive investments are often under-utilized. For our part, we physicians have a valid point that EHRs can create extra administrative burden that takes time away from caring for our patients. Plus, pointing and clicking on a computer screen and typing on a keyboard is not what we learned in medical school. Layering on top of those challenges, most standard EHR interfaces aren’t intuitive enough for physicians to easily capture the full clinical story. Let’s face it, all this typing takes the joy out of medicine, creates frustration and entices many physicians to document in the EHR’s free form text fields because it mimics how we documented in legacy paper systems.

What results, however, is an incomplete patient record that increasingly will impact reimbursement as risk-adjusted payment models become more prevalent. The issue takes on more negative impact as we physicians soon will be measured publicly on our risk-adjusted quality scores, which are based on the accuracy and completeness of our clinical documentation.


Don’t replace the EHR – embed enhancing tools instead

Frustration with EHR usability might lead to the tempting thought of throwing the baby out with the bathwater – i.e., just going back to paper or replacing the legacy system. Neither alternative is practical. Non-adoption has too many negative financial and quality reporting impacts, and replacement is cost prohibitive when you factor in purchasing new hardware, software, and implementation and training costs. The dilemma is leading many physician practices to the attractive option of augmenting their EHR with embedded applications.

In fact, 75% of the respondents in a recent HIMSS Analytics study reported that it’s their top priority to introduce EHR-enhancing technologies to improve patient flows and realize better financial outcomes. These support tools include mobile devices and apps, computer-assisted physician documentation (CAPD) and speech recognition software.

In response, major EHR and healthcare technology vendors are partnering to design embedded solutions that remove the structural and workflow barriers keeping physicians from documenting during patient care.  For example,  when you integrate an artificial intelligence (AI)-powered CAPD solution with an EHR system, you’re able to automatically provide real-time, clinical documentation improvement (CDI) feedback to physicians in a non-disruptive way.

Electronically analyzing all relevant patient notes with deep learning and natural language understanding  helps to automatically identify clinical indicators in a patient’s medical record and advises the physician when there is important missing information that needs to be clarified. This helps improve severity-adjusted quality scores and capture appropriate reimbursement critical to proper care and management of patients.


Embedding innovation for a better physician experience

The rising tide of EHR adoption is not going away, but there is a direct correlation to an increase in physician dissatisfaction. It’s a dilemma that impacts all stakeholders in the U.S. healthcare system. Embracing augmenting tools that offer AI technology guidance into the physician’s EHR experience appears to be a pragmatic and powerful approach to removing physician frustration while promoting higher quality documentation at the most affordable cost.


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Dr. Anthony Oliva

About Dr. Anthony Oliva

Dr. Anthony (Tony) Oliva is the vice president and chief medical officer for Nuance’s Healthcare division. Dr. Oliva draws on more than 15 years of executive healthcare experience. As chief medical officer, he personally has been involved with the implementation and expansion of clinical documentation programs since 2004. Previously serving as chief medical officer for Borgess Health, Dr. Oliva was accountable for the clinical practice of medicine across all Borgess Health entities including ambulatory care, hospital care and extended care services. He is currently Board Certified in Family Medicine. Dr. Oliva received an M.S in Medical Management from Carnegie Mellon University Heinz School of Public Policy & Management. He is a Certified Physician Executive, a designation earned from the American College of Physician Executives.