After five independent orthopedic practices merged to form OrthoVirginia, the organization faced a new challenge: increasing provider satisfaction with its chosen electronic health record. “We assumed that if people weren’t happy, they would put in a ticket,” said OrthoVirginia Chief Information Officer Terri Ripley during a recent HIMSS20 Digital presentation. Instead, she said, concerns would arise at inopportune times: “Hearing of issues during a board meeting is never a good idea.”
A survey in 2017 showed that OrthoVirginia providers were at the 31st percentile for EHR satisfaction within the United States. During their presentation, Physician Satisfaction With EHR: Is It Possible to Improve?, Ripley and OrthoVirginia Chief Medical Information Officer Dr. Harry C. Eschenroeder Jr. explained how the health system demonstrated methods of improving the cost of the technology, the completeness of the patient record and efficient EHR use.
“With the physician satisfaction results in hand, we knew we needed to improve,” said Ripley. “We realized we didn’t have enough active engagement with the physicians. We knew we had to come up with a way to engage our physicians other than once a month sitting on a phone call.” In response, OrthoVirginia created a new position: the physician support specialist. “To some extent, this has been our secret sauce,” said Eschenroeder.
OrthoVirginia selected one physician support specialist from the organization’s scribe group for every 40 providers or so to round the organization’s 25 locations. Initially, they acted as so-called firefighters to try and solve physician EHR problems in the short term. Eventually, the role became more proactive: Specialists would be assigned a specific teaching topic and then would return to ensure their lessons were implemented.
“They were uniquely suited,” said Eschenroeder. “They tended to be young, smart and resilient. They’d had experience with providers, so on a bad day when a provider was not very approachable, they could handle the idea of ‘getting their head bashed in’ and come back for more. They learned that providers were often grateful for their help.”
The specialists, Eschenroeder noted, used their interpersonal skills and knowledge base to liaise between the EHR team at Epic and physicians. “These people were very good at forming personal relationships, and they were competent,” he said. “They became multi-lingual in the ability to talk to the providers and also the builders.” OrthoVirginia’s other strategies included giving providers more documentation options – such as scribes, voice recognition and templates – and bringing in physicians with strong opinions as “champions” to collaborate on large projects.
“We engage them and give them the opportunity to build and make something, and it tends to make them committed,” said Eschenroeder. After a year, OrthoVirginia physicians measured at the 78th percentile for EHR satisfaction. That rate, said the team, is continuing to improve. Although these techniques were specific to OrthoVirginia, Eschenroeder believes other organizations can benefit from them as well. “I think our concepts we’re using are important, and I do think they’re scalable,” he said. As one example, he said, a local hospital system “took some of the ideas … and they’ve really had success.
