'Happy hour' improves EMR usability: Q&A with MU Health Care's Dr. Jeffrey Belden

Jeffrey Belden, MD, a family physician and professor at University of Missouri Health Care in Columbia, helped launch the medical center's "EMR Happy Hour" sessions that allow clinicians to gather and troubleshoot issues within the system.

Dr. Belden serves as medical director of interoperability at the Tiger Institute, a technology collaborative between the University of Missouri and Cerner. With a special interest in EMR innovation and usability, Dr. Belden is the founding and former chair of the Healthcare Information and Management Systems Society EMR Usability Task Force. 

Dr. Belden and his colleague Margaret Day, MD, a family physician at MU Health Care, started the EMR happy hour sessions to create a space for clinicians to collaborate and share insights on solutions for EMR issues such as charting, documentation and ordering.

Here, Dr. Belden discusses the inspiration behind the happy hour sessions and what he thinks clinicians find most frustrating about EMRs. 

Editor's Note: Responses have been lightly edited for clarity and length.

Question: What sparked the idea behind the EMR happy hours?

Dr. Jeffrey Belden: We noticed that our occasional elbow-to-elbow encounters with colleagues often proved fruitful. We decided to scale that up with a monthly small group meeting during protected faculty development time.

Our other physician-to-physician training tools included 'Tip of the Week,' 'PowerChart Moment,' and using a 'time' motif. EMR Happy Hour seemed a natural. Why not learn something helpful and go away happy? No alcohol required.

Q: How have the happy hour sessions affected physician workflow?

JB: Every attendee reported some efficiency gains, reduced frustration and moral support.

Q: What other initiatives has MU Health Care taken to improve EMR usability?

JB: Our chief medical information officer has a monthly email newsletter that informs physicians of EMR enhancements and other changes. We also have a formal collaboration with our EMR vendor Cerner that is called the Tiger Institute, where the mission includes new developments aimed to enhance efficiency and reduce mental load. We have a grant team funded by the Agency for Healthcare Research and Quality that has developed graphical displays of blood pressure for collaborative decision-making by patient and physician, which is a product of the Tiger Institute partnership. 

We recently improved our nursing clinic interview form dramatically, which we were able to do because the EMR software got a better set of tools to make the tool more efficient and do the math for our nurses. We just finished doing usability testing to see if it's faster, more accurate and easier to use. That analysis is in progress.

Q: What do you find frustrates clinicians most about the EMR?

JB: The amount of time and effort it takes to document the work we do, which has to satisfy more than patient care needs. Billing, medico-legal and quality measures have invaded the notes we write to support patient care.

Far too many physicians spend part of their nights and weekends finishing their patient notes. It's a complex problem that involves many stakeholders including government, insurance payers and quality organizations.

To participate in future Becker's Q&As, contact Jackie Drees at jdrees@beckershealthcare.com. 

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