Question

Physician practice EHR reselection

A physician practice is located in a large medical office building. The practice has 15 providers, including 8 primary care, 3 cardiologists, 2 endocrinologists, and 2 geriatricians. Several years ago, they acquired an EHR that was selected as a joint effort by various practices in the building. From the start of its use, several of the physicians voiced concerns about the product not being user friendly and one of the cardiologists refused to use the system. The cardiologist’s notes were scanned into a complementary EDMS system so they would be accessible to other providers. Most of the primary care providers, however, found the system helpful for its ability to provide preventive service reminders and to help them make medication therapy choices, although all continued to believe the system slowed them down considerably. Two of the primary care providers and the two endocrinologists have seen significant improvement in their diabetic patients’ A1c measures as result of the system’s tracking capabilities, but are frustrated that the system does not interoperate with the same vendor’s products in other offices in the building to whom they refer patients.

Recently, a rheumatologist joined the practice. The rheumatologist is also a medical informatician who has worked with one of the major e-prescribing vendors. She suggested that the providers needed help with their workflows, especially relating to how they interact with their patients during note taking. She suggested physicians could better use nurses, front-office staff, and patients or their caregivers to enter some of the patient’s personal health history information, which would also improve patient engagement by being able to monitor their health outcomes. Several physicians, however, want to acquire a different EHR. They believe that one that is cloud-based will give them interoperability with their colleagues. They further make the case that their current vendor provides add-on portal functionality (for quite a steep price) but not a personal health record. They do not want to give patients access to their EHR via a portal, believing it will allow patients to change the notes physicians have made about their patients.

Discussion Questions

1. What are (3) of the false assumptions being made by the physicians in this case study?

2. What (5) workflow changes could be anticipated?

Answer 1

1)The false assumptions being made by the physicians in this case study are as follows:-

a)The product(EHR) not being user friendly and one of the cardiologist refused to use .

b)PPhysician assumed that the system provide preventive services reminders and help them make medication therapy choices but it slowed down considerably.

c)The system does not interoperate with the same vendor's products in other office in the building to whom they refer patients.

2) Workflow changes that could be anticipated are as follow:-

a)Rhematologist suggested that the system would interact with their patients during note taking.

b)Better use of the system by entering some of the patient's personal health history information which would also improve patient engagement by being able to monitor their health outcomes.

c)EHR with cloud based will give physician interoperability with their colleagues.

d)Their current vendor will provide add on Portal functionality for quite a steep price but not a personal health record.

e)Physician do not want to give patients access to their EHR via a portal as it will allow patients to change the notes physicians have made about their patients.