EMR Templates

I’m always fascinated by a discussion of EMR templates. A little while back on the 3M blog, they wrote what I think is a pretty good summary of the pros and cons of EMR templates:

Using template-based documentation provided by most EHR vendors allows for documentation to be available almost immediately for communication with the rest of the care team, which is important especially for daily progress notes. Choosing templates over dictation-transcription eliminates the variable of transcription turnaround time, which can range from a few hours, to a day or more. Templates also allow documentation to be created in a consistent and structured format, with up-to-date problem lists.

There are clearly many benefits associated with the use of templates, however from what we’re hearing there also are a number of drawbacks to this strategy. Coding, communication with other care providers, and physician efficiency can all be impacted by template-based documentation. We’re seeing that physicians don’t capture as much information when they fill out a form-based template as they do when they are allowed to capture the patient narrative in their own words, either through writing or dictating. Key information may be missing, which impacts both the care team and coding—and could result in the dreaded “every patient looks the same from the documentation” issue. Some physicians tell us that templates slow down their daily workflow, making them frustrated with their organization’s EHR implementation.

The discussion of EMR template use is a complex one. In many cases you can see the benefits of using an EMR template, but there are also a lot of downsides to their use. I remember when Dr. West wrote a blog post about why he loves his EMR templates. As I thought about his views I realized what the difference was in his templates and the templates that many other doctors use. He created his own EMR templates that were specific to him. I think that makes all the difference in the world.

Turns out that no one really hates EMR templates or loves EMR templates. They’re just a means to an end. What then are the benefits and challenges of using EMR templates.

EMR Template Benefits:

  • Saves Time (if designed well)
  • Helps Ensure Standard of Care
  • Documentation Always Found in Same Location on the Page

EMR Template Challenges

  • Every Chart Looks the Same
  • Lots of Clicks (if designed poorly)
  • Abnormals are Difficult to Identify
  • Difficult to Document Multiple Chief Complaints
  • Template Not Physician Specific (or takes a lot of time to create ones that are)

I’m sure there are other points worth noting. I look forward to hearing which ones I might have missed in the comments. I think the key when considering templates is how to make sure you get the benefits while mitigating the down sides. I think this is possible, but it takes some time and a thoughtful approach to make it happen.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

2 Comments

  • John makes a good point. When done right, templates can be an indispensable help. Conversely, an EMR can almost be rendered useless when its templates are poorly designed or too general. In response to this issue, SOAPware has become one of the only EMR systems that allows users to design and share their own templates with thousands of other practices. We believe that this will allow simpler and more cost effective customization for different medical specialties.

  • Does it make sense to have the physicians be the ones focused on using these tools? The evidence is that it takes 9 times longer for physicians to fill out structured templates than to dictate. They can cut this waste down dramatically by using cloning and cut/paste, but then you risk having data that hasn’t all been validated. If a physicians sees 20 patients, you have turned 20 1 minute dictations into 3 hours of pointing/clicking/scrolling/typing/navigating. What sense does it make to have the most expensive employee doing clerical work and who becomes the bottleneck to throughput and the ability to manage a larger panel of patients? This only adds costs when reducing costs are going to be the key to success in the new payment systems.
    Let the care team and the patient capture the needed, structured data that can be reviewed and corrected by the care team quarterback. Unfortunately, almost all EHR software as well as their implementations are designed to turn doctors into data trolls.
    This will soon be the path to non-sustainability and the unloading of overpriced, obsolete systems and methods.

Click here to post a comment
   

Categories