Like many emerging software products, Electronic Health Records (EHRs) have suffered from an emphasis on technology.  Product design has been dictated largely by what was possible rather than on what was the best fit for the medical office, especially in smaller-to-medium size practices. In addition, product designers have been more likely to come from a technology background rather than a medical one.

But as with all technologies that mature and become truly integrated into the environments that they serve, EHRs have evolved.  More and more, EHR product design is being dictated by workflow – and no longer the other way around. And especially in smaller-to-medium size practices, this is a critical component of widespread adoption.  However despite the increased attention on EHRs, an estimated 90 percent of private physicians still use pen and paper for notes they take down during visits.

Efficient Workflow Depends on Ease-of-Use

Now that EHRs are in more common use among smaller practices, some key lessons have been learned.  Ease-of-use is now acknowledged as the most important feature of any EHR system and a key attribute to integrating EHR into the workflow of a practice. The reason is simple. In order to be effective, an EHR must be used and embraced not only by physicians, but by their staff members as well. And in many small practices, one of the physicians or a staff member serves as the in-house IT person/helpdesk, therefore, a user-friendly system is critical.

Integration with medical office workflows is a key component of ease-of-use and crucial to a smaller or medium practice. Everyday operations such as scheduling an appointment, writing or refilling a prescription, or creating a referral letter, must be intuitive and straightforward – achievable quickly with a minimum of clicks and data entry. And it goes beyond mere efficiency – if it does not fit into practice workflow, the EHR implementation will likely fail. The staff of a smaller or medium practice is simply too busy to adjust their workflow to accommodate a new system dictated by an EHR program.

Improving Health Care Accessibility through EHRs

By streamlining health care management with EHRs physicians will reduce medical errors and improve quality of care.  Broad adoption of EHRs has the potential not only to improve the quality of care provided, but also to transform the way medicine is practiced and delivered.  In addition, EHRs can make it easier for physicians to identify various serious illnesses and prescribe relevant treatment for their patients.  Overall, EHRs can help to improve communication between providers and patients, giving patients better access to timely information.

Benefits to Implementing a Workflow-Friendly EHR System

There are vast benefits to implementing an EHR system that integrates smoothly into practice workflow, significantly impacting the physician, the practice staff and the patient. These benefits are felt perhaps most strongly in small practices where staff members often wear multiple hats. For instance, the filling person may also be taking patient calls and scheduling appointments, and in instances like these, an EHR is almost indispensable. 

In a small and medium practice, the value of time cannot be calculated. Instant access to a patient’s electronic health record saves the clinician’s staff time and enhances efficient workflow. For example, in a small office, there is not a designated staff member to pull and route charts. An EHR alleviates the need to sort through cumbersome paper charts as simple electronic searches can retrieve a patient’s complete medical record from any office desktop. Before seeing a patient, staff members are able to review the patient’s medical history, current medications, problem list and more. These time savings are invaluable and improve patient care.  In addition, they have proven to increase the daily number of patients physicians are able to examine or visit with.

Efficient Workflow is the Key to EHR Success

The market is flooded with EHR products, but what physicians in small- and medium-sized offices are truly looking for is not just software that provides a charting solution, but a cost-effective product that manages their day. Physicians want a solution that automates their office while enabling consistent high quality care and increasing patient loads – but does not dramatically disrupt workflow. They are not interested in technology per-se, but a practical and affordable solution to everyday practice problems.  Fortunately, more EHR products today are being designed with these goals in mind and the smaller-to-medium sized practice, and more importantly, its patients all stand to benefit.


Author: Jack Smyth, President and CEO of Spring Medical

Jack Smyth’s article is published in EHR Scope Spring 2008 Volume 5 publication.  To view his article please visit