Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

A plug for the EHR 


Clinicians can make EHRs work better by keeping patient records up-to-date and utilizing features like customization and search. Impressive new features are coming—hang in there! 

I’ve been a proponent of electronic health records (EHRs) for most of my 30-year medical career. While much of the grumbling about EHRs from the early days has died down, it seems like many people still have a love-hate relationship with them. We don’t miss illegible handwriting, flipping through reams of paper, and hunting for charts. But we feel like the patient’s story has been lost among all the screens, notes are bloated and hard to read, and we cringe to see physicians typing away at a computer whether they’re facing the patient or (worse) turned away. We hear about the potential for precision medicine and artificial intelligence to transform healthcare, but it’s all just taking so long.


I assure you that amazing new developments are well on their way that will better support personalized patient care, improve clinician efficiency, and collate and present information in ways that seem magical. But until we get there, here are five things both in and outpatient clinicians could do better now to make the EHR work more effectively for themselves, their colleagues, and their patients.


1. Update and maintain the medical history.

The medical history is supposed to be a list of all of a patient’s current and resolved diagnoses. While it takes a little time to update, a well-maintained medical history can eliminate the need for you and your colleagues to hunt through past notes for diagnoses and can be used to trigger clinical decision support that improves quality of care.


2. Update and maintain the problem list.

The problem list should be a list of a patient’s active diagnoses. A well-curated problem list helps you hone your attention on important diagnoses from visit to visit. As conditions improve, add them to the medical history, if they’re not already there, and then resolve/remove them from the problem list.


3. Update and maintain the home medication list.

The home medication list should contain the correct doses and frequencies of everything a patient is currently taking and/or prescribed. An accurate medication list is key for managing treatments, being alerted to potential drug-drug interactions, and prescribing efficiently.


4. Personalize wherever possible.

Most EHRs enable users to customize multiple aspects of their system, streamlining workflows to meet their needs. Taking the time to personalize tool bars, order sets, note templates, and “dot phrases” (when available in your system) can maximize efficiency and decrease the stress of using the system.


5. Utilize chart searching functionality.

Most likely your EHR gives users the ability to do keyword searches on the entire patient record. Want to know if the patient had a DVT in the past, or how they responded to amoxicillin the last time it was prescribed? Entering a few select terms can lead you straight to the information you need, like a good Google search.


While EHRs haven’t reached their full potential yet, by implementing these simple strategies and embracing continuous improvements, we can make them work for us, not against us. Let’s leverage technology to enhance patient care, streamline workflows, and reclaim the human connection at the heart of medicine.









This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.