EHR Optimization: Where to Start

Whether your EHR has been live for years, or you just installed it, there are probably ways you can improve how you use it. Was your system designed to ensure optimum revenue? Are your clinicians happy, or do they change the way they work to accommodate the computer? Are you meeting all of healthcare’s ever-changing regulatory requirements? Let’s face it, not many organizations can say that they’ve maximized their EHR investment 100%.

Where to begin can be daunting, though — especially if you’ve just survived going live with a new system, or your EHR has been live for many years and upgrade features haven’t been turned on and you hear complaints. To get the most out of your investment, it’s essential to plan for EHR optimization.


The actual work needed to optimize your EHR system will look different for every organization. But in my decades of experience with EHR optimization projects, I’ve found that the process for uncovering opportunities for improvement — and developing practical solutions — is largely the same.

Here are five tips that can help you identify and prioritize areas for optimization.

1. Establish an Optimization Team

The best strategy for EHR optimization is to start making improvements right away. But to accomplish this, you’ll need to ensure that the right people within your organization are involved. Instead of pulling in resources to address issues “as needed,” establish an EHR optimization team. From my experience, here are the roles that should be included in your team:

  • Assessors: These people serve as your “boots on the ground,” helping to observe, identify, and assess issues that should be addressed. This can include reviewing available data and service requests, as well as conducting in-person observations in departments and on the floor.
  • Builders: Include members of your IT team that have already participated in building certain areas of the EHR system. These individuals will be responsible for building new components and/or making the necessary system changes.
  • Trainers: When system changes will be made, or if recurring problems are observed that result from a misuse or misunderstanding of your EHR system, these team members can develop training plans to roll out system changes and/or address issues.
  • Interface Experts: These individuals have the skills needed to work on issues that involve EHR interfaces – existing interfaces, or new ones that are needed.
  • Governance: Representation from leadership is appropriate and essential to EHR optimization, since it impacts everyone. This person (or people) will ensure prioritization and significant changes are communicated to and approved by senior management, and that leadership will help ensure proper change management takes place.

2. Examine Your IT Tickets

Once your EHR optimization team is established, it’s time to start identifying areas for improvement. Your IT staff receives tickets from users across the organization. Each ticket represents a challenge someone has encountered using your EHR system.

Start by categorizing your tickets into groups that represent similar challenges. Then, let your EHR optimization team prioritize them and build a plan of action. Some specific challenges may have many tickets, and some may require minimal effort to address — perhaps start there to score some quick wins. Others may require considerable system work and organizational change, but if they could have high impact (for example, if they’ll improve revenue substantially or save clinicians significant time), you may want to give those high priority, too.

3. Assess Internal Information

Many issues, however, will not have IT tickets. You’ll need to identify those by proactively analyzing your organization’s internal data and metrics.

Task the “assessor” members of your EHR optimization team with looking for these optimization opportunities. They can survey users (and don’t forget patients who use your portal) — I find that people are usually eager to provide feedback on how you can improve their experience. Your assessors can also look at system metrics from your EHR system itself.

For example, high claims denials could link back to an issue with how patient information is being entered during registration. And data from your EHR analytics — like Epic’s Signal tool, for example — can tell you if users are spending too much time on certain workflows (a sign of a potential usability issue).

4. Include Regulatory Changes

There’s always a new regulatory requirement approaching. To ensure your organization complies with these changes, pay special attention to how each upcoming regulation will impact your EHR system. For example, the Medicare Access and CHIP Reauthorization Act (MACRA) brought with it significant implications related to remote access to patient data. And the deadlines varied between hospitals and physician offices.

Keeping an eye on regulatory changes will allow you to develop a plan to address each change and meet any required timelines.

5. Maintain Clear Communication

Communication is key during the EHR optimization process. As you identify and prioritize problem areas, be sure to communicate your upcoming plans. If your staff knows that an issue is going to be addressed, they’ll be less likely to develop their own workarounds.

The same is true when it comes to EHR system upgrades. If you’re turning on a new feature, let the impacted staff members know in advance and provide additional training, if needed.

Most importantly, encourage real-time feedback throughout the optimization process. Staff feedback can be vital to developing more efficient workflows and achieving overall success.

The end goal of optimization is to make your EHR system work for you — not the other way around. If you follow the tips outlined above, you should be well on your way to creating a better experience for your staff, providers, and patients. But if you need a helping hand, our experts at HealthNET Consulting are available to assist. Just contact us to learn more about the EHR Optimization services we provide.

Blog Post Author:

Karen Mingain

Karen Mingain, PMP, Director
HealthNET Consulting

Karen Mingain is a Project Manager with more than 25 years of expertise leading successful implementation and optimization projects throughout the healthcare industry — at inpatient acute care facilities, ambulatory clinics, physician practices, home health, as well as CVS Health and Massachusetts eHealth Collaborative. A strategic planner who helps organizations increase efficiency, reduce costs, improve resource management, and optimize processes to boost productivity and achieve clients’ strategic goals.

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