The next to last step to work on, on your march towards EMR mastery:
Step 4: The 80/20 Rule
Also known as “The Pareto Principle,” the 80/20 Rule is extraordinarily useful. It’s a principle of economics and management, and is most often cited today by entrepreneurs (like Tim Ferris) needing to keep vast amounts of data and responsibilities manageable. Sound familiar?
At the EMR 101 level, the 80/20 Rule goes like this:
- the vast majority of your daily patient encounters occur around a handful of clinical diagnoses
which translates into
- the vast majority of your daily documentation can be done with a handful of templates or pages.
This was alluded to in the last post, under Step 2: Get Familiar With TWO Workflows, Tops. You can go far with this one; long after you’ve graduated to speedier, more specific templates, you’ll still be able to fall back to your “old faithful” workflows whenever confronted with a condition laying outside of what your EMR was designed to handle.
But this principle extends way beyond this:
- 80% of your headaches come from 20% of your patients
- 80% of your office income comes from 20% of your health plans
- 80% of your inbound calls are about the same 20% of daily tasks (e.g. refill requests and lab reviews)
- 80% of your going home late comes from 20% of your documenting habits (e.g. doing crib notes, then going back later to reconstruct the full notes)
- and so on
Once you start seeing these trends, you can start to prioritize where to direct your attention most efficiently. In medicine, of course, you’re trying to encompass 100% as your goal; the 80/20 Rule is NOT about letting 20% of your work go undone, or missing the critical diagnosis 20% of the time!
But if you’re swimming in a morass of seemingly undifferentiated tasks, this rule can identify what to fix first to give yourself the most breathing room. Make 2 or 3 changes that lift the “crush” of your workload off of your back, and you will be much less worn down.
And “much less burnt out” means “less likely to miss critical things.”
Take That Step, You Can Do It
Think about it: take a bit of time now — when you’re floundering, I know — to regain yourself heaps of time from now on.
Push back from your desk and find a handful of problems to fix — pick 2 to start with. I’ve had great success with the following, which ultimately enabled me to end my workdays about an hour earlier than before:
- batch processing lab reviews or med refills for 15 minutes at noon, and 15 minutes at the end of the day (instead of sprinkled throughout the day — barring any urgent values, of course)
- finishing notes as you go, and getting rid of the “crib notes/reassemble later” habit
See how much time and energy you get back with just those changes. Then look again, find some more “big bang for your buck” issues, and go at it again.
Reclaim your day, one swipe at a time.
Next time: EMR 101, Part 3 – The Final Chapter
