February is proving to be a busy and exciting month. In my new role as Clinical Informatics Nurse at Meta Healthcare IT, I have been actively engaged in redesigning how we demonstrate our product. This opportunity allowed me to focus on those aspects of an EHR important to evaluate up front. I am learning there is a paradox in EHR development. On one hand there is a need to develop structure in individual modules such as eMAR, CPOE, and clinical documentation. On the other hand, a measure of a successful EHR, is the ability to function as an integrated tool for all individuals involved in the care delivery organization. This insight gave me food for thought as I was reviewing our own product.
EHRs are complex with a great deal of content. As I struggled with the question of “what do I show?” I realized the person on the other end of the demonstration struggles with the question “what should I be seeing?” What should a nurse want an EHR to do? As stated in my last blog nursing involvement in the organizational review and selection of an EHR is vital to successful and sustainable implementation. So what to look for? In reviewing an EHR, the first thing I would look for is COMMUNICATION. It is important to evaluate how well each of the modules communicates with the other and ultimately how well the communication passes on to the nurse.
For instance if a provider places an order in CPOE, how does the bedside nurse know the order has been placed? The communication of a new order should flow from CPOE to the nurse immediately and be highly visible. A nurse should not have to seek out new orders or open multiple screens to see order details. How easily is communication shared? Because care delivery is an interdisciplinary process your EHR needs to provide information at an appropriate level for each member of the care team. Is there an ability for care team members to communicate within the EHR product on topics not necessary for legal patient documentation? If I spend my entire day within an EHR I should not have to resort to “sticky notes” at the nurses’ station and if this is the case, then the EHR is not doing what it’s supposed to do.
A good strategy in an EHR review is to examine current communication methods within your organization and evaluate the EHR product for a strategic fit. A well designed EHR will enhance communication and the ability to coordinate care and care delivery teams.
Next time I will focus on how the EHR should provide flexibility to support your care delivery model from a unit to organizational level.