EHR and Cognitive Drift

Cognitive Drift

Many DCs are using electronic health record (EHR) systems to make their lives easier when it comes to office organization and record retention. These types of systems also improve chiropractic care for the patient. By offering some convenience-based services such as free online patient portals, email and text reminders, and sign-in kiosks, there’s no denying that an electronic records system provides many patient advantages.

However, there is one issue with some EHR systems that are common but rarely talked about. It’s a matter that impacts patient care, job satisfaction, and EHR adoption. And this issue can be summed up in two words: cognitive drift.

What Is Cognitive Drift?

Perhaps the best way to explain cognitive drift is to imagine that you want to search google. You find a web page you like and click the link. Then you wait and wait, and wait for the page to load.

You may only wait a few seconds, but during this time, your mind wanders or drifts to other areas. Maybe you start thinking about your rumbling tummy, and you’d like to get something to eat, or perhaps you start to replay a fight you had with your spouse or kids last night. This distractive condition is called cognitive drift.

Regarding EHRs specifically, cognitive drift refers to the sustained lapse in mental focus which occurs with a poorly responding EHR system. Only a 1 second can lead to cognitive drift. In fact, research has found this one factor alone can be detrimental to both you and your patients.
The Negative Effects of Cognitive Drift

A study conducted by Dr. Macaulay Onuigbo, a nephrologist and transplant physician at Mayo Clinic Health System, involved ten intensive care unit (ICU) physicians. When surveyed, all of these ICU doctors reported that it was “very common” to wait 10 seconds for their EHR system to respond. This left them feeling frustrated and repeatedly distracted throughout their day.

Dr. Onuigbo stressed that these types of responses—experiencing frustration, becoming distracted, and losing focus—increase the likelihood of medical errors. Whether you become impatient or your mind wanders, you run the risk of inputting and retrieving incorrect information to and from the EHR system due to any time lapse. These errors in documentation can reduce patient satisfaction and outcomes levels, all because you’re not fully engaged.

Dr. Onuigbo also points out that a lengthy delay between asking for electronic information and displaying the information also increases stress levels and risk of burnout, two emotional factors that impact how you provide patient care. For this reason, in a letter written to and published by the Wisconsin Medical Society, Dr. Onuigbo indicated that “a functional EMR…should virtually eliminate the phenomenon of cognitive drift simply by being extremely fast.”
So what type of EHR system is that?

Choose an EHR Which Reduces Cognitive Drift

One way to reduce cognitive drift is to choose an EHR system which is server based. A server-based EHR uses a local network connection (LAN) which can be faster than a cloud-based EHR which uses the Internet. A responsive LAN server removes the possibility of time delays due to the bottleneck effect of slow web services.

Another option is to utilize an intuitive EHR. Chuck Webster with The Healthcare Business Process Management Blog describes this type of EHR as one “the user can use…without having to consciously stop and figure [it] out.” Essentially, it is a system based on both instincts and habitual behaviors, making it easier to use.

The primary goals of an intuitive EHR system are to reduce “click-through” rates and eliminate double entries. One way to do this is to have EHR records seamlessly linked to the patients billing records. Additionally, a layout designed with tabs to toggle between views is much more efficient then pop-up windows that block information below and requires extra clicks to close. All this makes workflow from one task to the next move in a natural and orderly way.

It also helps to choose a customizable EHR that specifically in areas such as charting, billing, scheduling, and marketing. This feature allows you to set up the EHR in a way that makes the most sense for you and your practice.

Finally, benchmarking your EHR helps too. Certified Healthcare Business Consultant Keith Borglum explains that benchmarks are data points which are used “to track the performance ‘vital signs’ of your practice.” In other words, it can help you identify and correct issues that are adversely affecting your chiropractic business, such as inefficient office procedures, inaccurate coding practices, and redundant patient processes.

So while EHRs offer a lot of advantages, if you choose one that has a 10 second or more lag, you may be creating problems for yourself and your patients. Problems where none need to exist.
Instead, choose an EHR that is server based, intuitive, and customizable. And benchmark your progress with it. Then you’ll have an EHR that enhances your success as opposed to one that detracts from it by killing your patient care…and your profits.

See Quick DemoWATCH HERE