What EHR Metrics Really Matter?

The health care industry has focused on physician adoption numbers as a primary success metric. Most EHR vendors tout the number of physicians who have purchased or created a login for their EHR solution, or the number of patient charts created. At Elation, we’re taking a different approach. In this post, we’ll explain that approach, and how our unique success metric reflects our commitment to helping physicians provide quality patient care.

We set out to build a clinical tool that acts as the single place where a physician goes to find all the information relevant to their patients’ care. To do so, we must be able to capture all of the physician’s care-related activity and present it to the physician in an actionable way. Put more simply, Elation Health must be a tool that physicians use to help deliver all aspects of patient care.

To track our progress against this goal, we monitor a simple ratio: the number of unique patient charts opened per number of patients seen each day. We developed this ratio after spending a lot of time learning how doctors do their day-to-day work, and how they use EHRs in their practice.

Many people don’t realize that physicians spend a significant portion of each day caring for patients they didn’t see in person for an actual office visit. In fact, amongst Elation users, our primary care doctors are compensated for a surprisingly small percentage of all patients they care for on a given day. Processing prescription refill requests, responding to messages from patients, reviewing diagnostic test results, reading reports from other providers that are caring for the same patients are all things that happen outside of designated appointment times, and yet are critical to ensuring patients receive appropriate and thorough care. It is exactly these types of patient interactions that are not usually recorded inside conventional EHRs, for two reasons.

First, recording this work in a conventional EHR is difficult and time-consuming, and many doctors opt for paper because writing a note by hand is, unfortunately, faster than inputting information into an EHR. Second, most of this work, if not all, is not compensated under the current fee-for-service health care payment model. Since physicians use EHRs to record care they provide to patients for reimbursement or compensation, they’re unlikely to input any uncompensated work. If it takes longer to do in the EHR and it’s not required for compensation, physicians will typically take the faster approach and perform these activities offline on paper. As a result, valuable patient care information, including adverse effects, treatment changes, is missing from the patient chart in the EHR.

We designed Elation Health to make performing the activities between patient exams as easy and intuitive as it is on a paper chart. When we see that a doctor’s opened 60 patient charts in Elation Health on a day that they only saw 15 patients, it’s a key indicator of engagement with our system. It shows us that the doctor is consulting the system frequently, and is using it to perform all the uncompensated but important work they do outside of their appointments with patients. The high charts-to-patients-seen ratio tells us that doctors find our system helpful and easy to use. We also know that our doctors are not just opening charts to enter billing codes, but instead are engaging with them in a meaningful way.

The number of accounts we have, or the number of patient charts created in our system, are not the key metrics that matter to us. We focus on physician engagement because it’s central to how we help providers deliver quality care. This commitment to engagement drives our product design and company philosophy and helps us ensure that our tools are helping physicians do their best work. When physicians are empowered, everyone benefits.

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