Without a doubt, the digitization of patient health records and the rapid growth of software applications and systems supporting patient care and administration have changed the way medical care is delivered. As physicians, hospitals, and health systems struggle to see more patients, deliver better care – and comply with an ever-increasing number of other demands of their time – it’s critical that the applications and systems they rely on are available and perform as expected. When electronic health record (EHR) end user experience issues arise with these various technologies, downtime occurs, meaningful use objectives become more difficult to achieve and end users become susceptible to burnout.
Common systems-related issues that negatively impact end user experience include initiating logon to EHR systems and modules, issues with the logon process itself and sluggish session performance that slows down important end user activities.
It’s not hard to understand that proactively anticipating, troubleshooting and preventing end user experience can go a long way toward ensuring the productivity of healthcare professionals. In today’s fast-paced healthcare care environment, any difficulty and delay accessing or using mission critical applications creates stress and decreases the productivity of healthcare professionals.
A Common Challenge for Today’s Medical Worker: You’re Ready to Work but Your Technology Isn’t
Let’s take a look at how a poor end user experience impacts the typical day in the life of a physician – Dr. Smart – a high-cost medical professional responsible for providing care to patients while simultaneously being bombarded by administrative demands.
7:00 a.m. – Hospital Rounds. Dr. Smart arrives at Local Community Hospital and attempts to log into their patient registration module to print a list of patients she needs to see. Unfortunately, Dr. Smart encounters a problem logging on to the facility’s patient registration module. What typically takes less than a minute involves quite a bit more time. Fifteen minutes later, Dr. Smart begins her rounds and sees her first patient. The doctor just lost an average of three minutes per patient – and she hasn’t even seen the first one!
While examining her second patient, Dr. Smart discovers she’s unable to access the hospital’s electronic health record imaging order entry module. All she receives from the system is some cryptic system error message that reminds her of some of the incomprehensible prescriptions handwritten by a few of her fellow physicians prior to the advent of electronic RX applications. How great would it be if somehow that error message was automatically captured and shared with someone who could decipher it and act on it?
After spending 10 minutes on the phone with the hospital’s help desk, they congratulate Dr. Smart for discovering a new issue with the hospital’s imaging order entry module. Pleased to be of help but frustrated nonetheless, she writes the imaging order by hand and continues her rounds, jotting down information she knows she’ll have to rekey later in the day.
It’s 9:00 a.m. and Dr. Smart Has Already Lost an Hour of Her Time – Three Hours into Her Day
9:00 a.m. – She’s 30 minutes late meeting with her patients at her outpatient clinic; the waiting room seems more crowded than usual. For the next four hours, Dr. Smart sees eight patients, bouncing between six different applications she needs to provide care to her patients. These applications include:
- Her clinic’s EHR system (Allscripts Professional EHR™ hosted by a 3rd party)
- Her clinic’s on-premises practice management system
- The Local Community Hospital’s EHR to access radiology reports (Epic’s Community Connect™ EHR)
- Two different Laboratory Information Management Systems (LIMS)
- A new telemedicine application hosted by a 3rd party
- The EHR at nearby Level II Trauma facility (Cerner CommunityWorks™ EHR)
Application Access & Performance Issues Compound Throughout the Day
In the four-hours since her day started, Dr. Smart logs on, off and switches between these six different systems so many times she’s lost count. But she definitely remembers the types of issues she encountered along the way:
- Unable to access Local Community Hospital’s EHR to check on some radiology reports (Logon Initiation)
- A 10-minute interruption while her clinic’s power user contacted the Local Community Hospital’s regarding her inability to access certain patient records (Logon Process)
- About a dozen 1-2 minute delays she believes is related to her clinic’s Allscripts EHR. (Session Performance)
Software Issues in the Second Half of Dr. Smart’s Day – It’s Déjà vu All Over Again
Let’s see how the remainder of Dr. Smart’s day proceeds:
12:00 p.m. (Lunch) – Dr. Smart grabs a protein bar and a carton of milk from a vending machine in the cafeteria. She’s going to skip lunch today to help make up for time lost earlier. She’s a strong person and loves her role in helping to care for her patients.
12:15 – 5:00 p.m. – Pretty much a longer version of the first five hours of the day.
While the access issues encountered in the morning didn’t reoccur at the Dr. Smart’s clinic in the afternoon, Dr. Smart noticed several periods of extreme slowness when using the practice management system (hosted by a 3rd party). An inquiry by the clinic’s administrator to the vendor hosting the PMS resulted in nothing more than a claim that “everything’s running fine on our end.”
Hospitals & Health Systems Need Clear, Actionable Information on System Performance Issues
Dr. Smart wondered: ‘are the slowness and disconnects I experience random or is there a pattern of performance issues with our PMS? Seemingly on the same days and times week after week?’ If only the IT staff responsible for supporting these systems could pinpoint the exact root cause of these issues? Or, even better, proactively identify and resolve issues before doctors and other users are impacted? How would patient care improve and how much money could be saved?
5:00 p.m. – 9:00 p.m. – An Evening at Home Catching Up Using Remote Access
Remember the end user experience issues Dr. Smart had to deal with while doing her rounds at Local Community Hospital? As well as those imaging orders that she was unable to enter at her clinic? How about all the time she lost due to poor application response times? Well, those tasks had to be completed somewhere by someone, and that would be by Dr. Smart at her home office in the evening. Hopefully, the applications she has to access remotely are available and operating faster than earlier in the day.
5 Minutes Here, 10 Minutes There – Pretty Soon Patient Care is Delayed & Costs Increase
In her ten-hour day providing patient care at her clinic and the Local Community Hospital, Dr. Smart calculates that she lost over two hours of her valuable time just trying to access key software resources and perform the day-to-day duties of her job. And these delays associated with logging in, the logon process and session performance were not unique to her this day only but often occur in similar form nearly every day of the week.
All of these preventable interruptions were related to common technology issues that might easily be addressed by low-cost end user experience monitoring and management products currently available.
Identifying EHR End User Experience Issues Protects Hospital Software Investments
The good news for Dr. Smart and other healthcare professionals is that some hospitals, health systems and the information technology (IT) staff supporting them are starting to take a proactive approach toward identifying end user experience issues before they occur.
Some healthcare organizations are developing software utilities in-house but that approach is limited, must be maintained as end-user systems and applications change, and consumes critical IT resources. Other hospitals and health systems are using applications and features tightly bundled with their server, application and desktop virtualization and networking software – like Citrix and/or VMware. But these solutions are limited to their specific product sets and are not specifically designed for the healthcare applications that end-users like Dr. Smart use throughout their day.
Flexible, Cost-Effective Commercial Performance Monitoring Software
The Goliath performance monitoring and troubleshooting suite of tools provide everything hospitals and health systems need to ensure that the mission critical applications and systems needed by healthcare professionals like Dr. Smart to perform their life-saving work are available on a consistent basis.
- Automatically confirm that EHR applications and IT infrastructure are available, and if they are not, use embedded intelligence and automation to alert IT so they can fix the issue before physicians and health care workers are impacted.
- Anticipate, troubleshoot, and prevent end user experience issues where most users experience issues: logon initiation, logon processing, and system performance.
- Enable IT pros to quickly remediate problems and isolate root cause to reduce professional pain.
- Have broad and deep visibility to issues across multiple platforms, regardless of which IT infrastructure and applications are being used and where end users are located.
- Provide objective evidence through historical reports and trending analysis to allow permanent fix actions to be implemented to prevent issues in the future.
- Are purpose-built for major EMR/EHR applications including Cerner, Allscripts, MEDITECH, and Epic.
Moreover, the Goliath performance monitoring and troubleshooting suite frees hospital IT staff from having to build and maintain custom software utilities while expanding features and functionality beyond the limited focus of specific Desktop Virtualization vendors like Citrix and VMWare. Most importantly, a positive end user experience for people like Dr. Smart is preserved and the large investment hospitals and health systems have made in their mission-critical systems is enhanced.
About the Author
Steve Sisko is an independent healthcare consultant and blogger based in Phoenix, Arizona with over 25 years of experience serving the U.S. health care industry. Steve provides a range of information technology, service delivery, product marketing and management advisory services to health plans, health systems, risk-bearing provider organizations, product/service vendors and consulting firms.
Steve runs a popular, perennially high-ranking blog – The Healthcare Data, Technology & Services Blog – at www.shimcode.com and is a leading source of information on Twitter where he is known as @ShimCode. Learn more about Steve on LinkedIn: https://www.linkedin.com/in/stevesisko/