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A key piece of planning frequently mentioned by EHR implementation experts is "workflow redesign." As mentioned above, an EHR implementation offers you an opportunity to improve some of your less efficient processes through automation and fewer steps.

Ideally, for each major office process, we review the current paper process, analyze its steps and record them on a flow diagram. You can then determine if the process can be improved by comparing it to a flow diagram you create of an EHR process that accomplishes the same thing. Office processes that you should examine include medication refilling, telephone messaging, appointment requesting, lab reviewing, other test reviewing, prescription writing, patient check-in, health maintenance tracking, referral making, lab and test ordering, communicating test results to patients, interoffice messaging and note charting.

Not all EHR processes will be quicker and more efficient. Sometimes, though, a slower EHR process can pay off in other ways, making it worthwhile. For example, progress note documentation with an EHR is typically slower than using dictation or even a paper check-box form. However, by documenting directly in an EHR you immediately gain easily readable notes at the end of the visit. Notes can then be shared with patients or consultants, or the notes can be used for immediate review of those patient-care questions that arise before a dictation would normally return. Direct EHR note entry also commonly allows you to record diagnoses and populate problem lists simultaneously. These computerized problem lists facilitate a wealth of disease management and quality improvement efforts that can only be dreamed of in the paper world.