NIST offers recommendations for integrating EHRs into workflow

A new report from the National Institute of Standards and Technology (NIST) provides recommendations for EHR vendors and ambulatory care centers to improve the way EHRs are integrated into clinical workflow.

NIST used to workflow modeling tools as well as conversations with physicians and interdisciplinary teams to better understand the problem and possible solutions.

The report notes that people tend to create workarounds when EHRs don't fit smoothly into their work processes, but working outside the way the technology was intended can create problems of its own, such as those identified with using copy-paste.

Among the opportunities for improvement included in the report:

  • At-a-glance overview displays to enable physicians to adapt patient schedules to smooth out predicted workload.
  • Drafting predicted orders a day before a patient visit to reduce the time to complete the orders during the visit.
  • Supporting dropping or delaying tasks under high workload conditions.
  • Supporting different views of a progress note based upon role.
  • Distinguishing new documentation in a progress note from copied information.

The report suggests that EHR developers make it easer for staff to review results with the patient, draft pre-populated orders to be formally executed later, create designs that help the provider maintain eye contact and share information with the patient.

For ambulatory care centers, its recommendations include relaxing requirements to enter detailed data for others (administrators, billing/coding, legal, accreditation) during fast-paced patient visits, minimizing redundant data and designing rooms for patient rapport and EHR access.

The recommendations are aimed at changing EHR use from a billing-centric function to care-centric one, according to the report.

A medical scribe's article at recently suggested that pre-populating fields for patient visits makes it too easy for doctors to charge for tasks they might not have done, such as counseling a patient to stop smoking.

Black Book has predicted that usability will be a key determinant in market consolidation among EHR vendors in the coming years.

To learn more:
- here's the report