STAGE 7 SPOTLIGHT Shawnee Mission: Reducing Physician Burnout Through Real-Time Documentation
The electronic medical record adoption model (EMRAM) is a framework used to measure and evaluate the implementation and effectiveness of electronic medical records (EMRs) within healthcare organizations.
The EMRAM is relied on worldwide to identify and acknowledge healthcare organizations succeeding in innovating patient care from reducing physician burnout, to improving patient care through real-time documentation.
Achieving EMRAM Stage 7 is the recognition of a healthcare organization's commitment to improving the quality, delivery and cost of healthcare through the use of health IT. Let's dive into the implementation process of one such organization, Shawnee Mission Health.
Shawnee Mission Health (SMH) in Merriam, Kansas is a 504-bed facility that serves 222,000 patients for both inpatient and outpatient services.
Shawnee Mission Health's goal was to decrease late evening and night documentation for physicians by implementing a new IT documentation system. The Physician Documentation Improvement Project aimed to streamline the documentation process so that physicians could spend more quality time communicating with their patients and to reduce physician burnout.
The EMRAM Implementation
A series of new platforms were introduced: the documentation platform (Cerner Dynamic Documentation), voice recognition technology (mModal) and role specific (mPage) views. Training spanned over a two-month period and was done in both small group and individual sessions.
The implementation focused on helping physicians build better notes as they reviewed patient charts so they could spend time with patients, rather than looking at a computer screen and spending hours to document at the end of the day. Shawnee Mission Health used Cerner’s analytics tool to identify areas where physicians were struggling to effectively use the EMR and training was optimized for them based on that data. In addition, Shawnee Mission Health organized a quality team to ensure the quality and accuracy of physician documentation.
Shawnee Mission Health measured tangible results in increased savings, reduced medical errors, improved patient safety and outcomes, and increased physical space due to the lack of on-site files.
Intangible results were an improvement in clinician and patient satisfaction due to higher quality care and increased capacity, respectively. The sharp, measurable decrease in time spent documenting was a key piece in physician satisfaction.
Physicians were pleased with the ease of use of the new tools and approved of their efficiency. Currently, 90% of provider documents are structured forms with discrete data, 10% is dictation and 0.3% is handwritten or scanned. Both the medical team and the quality assurance team approve on the breadth of information in the notes via the new tool — specifically after introducing voice to text and eliminating copy forward functionality.
By utilizing the EMRAM, Shawnee Mission Health found that physician support, paired with concurrent training led to an increased adoption rate; resulting in the team creating custom commands and favorites within the tool that otherwise would not have been developed.
Gaining physician champions early on in the implementation process aided in physician buy-in and adoption. Word of mouth communication amongst provider peers was helpful in this key area of adoption. They also found that beyond gaining adoption through champions, it was beneficial to set clear deadlines on putting the system in place, learning and mastering it. The deadlines further accelerated the rate of acceptance and overall satisfaction with the new technology and process.
By undergoing a focused physician documentation project, Shawnee Mission Health has been able to not only improve the quality of life and satisfaction of providers, but also increase the quality of physician documentation.
Like Shawnee Mission Health, healthcare organizations around the world can use the EMRAM to drive innovation toward paperless and integrated information reporting and sharing initiatives that increase operational efficiency and prevent costly investments. Shawnee Mission Health is one of many examples of the proven benefits of EMR systems and how the HIMSS Analytics EMRAM provides a roadmap for EMR progression and maturity.