Electronic Health Records

Clinical experience is key to making EHR helpdesks useful

Nearly everyone has experienced the tedium and frustration of sitting on hold with customer service, trying to resolve a pressing issue, but being passed around from representative to representative just to find someone with the expertise to handle your problem.  It’s hard enough when it’s a malfunctioning television or an erroneous credit card charge, but it’s even worse when a physician is trying to document a patient’s life-threatening allergy before a surgery, and she can’t get access to the file she needs – or to anyone at the helpdesk with the clinical and technical skill to talk her through the solution.

Poor customer support is one of the top reasons that providers consider replacing their EHR systems, and with good reason.  Minimal training and a lack of ongoing guidance can turn a major investment into a major mistake, as an increasing number of physicians are finding out.  “Our first EHR was not very user friendly, and customer service was really lacking.  We just couldn’t get answers.  We were at the point of hiring a consultant just to help us navigate the EHR,” said Dr. Waseem Khan of Cancer Care of North Florida.  “It was really anxiety-ridden.  I think we had one or two days of support from our vendor, and then we were on our own, so that was really difficult.”

“A clinician like a physician who is in the hospital only one day a week doesn’t remember everything he should be doing as he logs on to the system, and so there will be a time when he has an issue—’I can’t figure out why my patient list is not as complete as I thought it was going to be,’ ” said Joe Francis, interim CIO of Detroit Medical Center to HealthLeaders.  “He needs to have someplace that he can get an answer quickly.”

That answer usually comes from a customer help hotline, a service that is being outsourced to dedicated companies with clinical software experts who can figure out what a physician or nurse is asking because they’ve been there themselves.  “I was with one of our physicians the other day,” said Chad Eckes, CIO of Illinois-based Cancer Treatment Centers of America, “and the physician says, ‘Every single time I’m in this clinical documentation note, all of these cells are grayed out, and I can’t do the documentation.’  And immediately the help desk would use PC Anywhere into the physician’s machine and see that the reason that the cells are grayed out is that they needed to click on one of the radio buttons at the top of the screen that says ‘Enter Allergies.’ And that would open up all of the boxes.”

Physicians experiencing such problems may be calling for help with a patient sitting in front of them, Eckes notes.  That’s not the time to become a human ping-pong ball with a series of representatives, or to be put on hold for an hour.  A quick answer from a trained tech support employee can get that consult moving again, keeping a physician on track and reinforcing the EHR training she had six months or a year ago.  An outsourced clinical help desk can increase physician satisfaction several times over: more than 70% of the physicians at Englewood Hospital and Medical Center in New Jersey expressed dissatisfaction with their in-house tech support service, but when the hospital outsourced its queries to a specialized clinical support group, the number flipped to 95% satisfaction.

“We spent a lot of time with our help desk and with the help desk personnel in putting together the documentation, the questioning that they should be doing, and identifying the things that they can resolve at that first call,” Francis said. “It’s really important that as soon as that call comes in, again, the quicker you can do it, the faster that that clinician moves on to continuing his care for the patient and goes on to his next adventure.”

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