Amanda Akers

4 Reasons Why an EMR Won’t Solve Your Surgical Preference Cards Problem

For most operating rooms in the United States, the preference cards problem is not a new one. Surgical preference cards are both integral to OR performance and a constant source of headache for OR staff and hospital supply chain leadership. OR physicians and nurses should be able to focus on patient care, and their valuable time is often spread thin. It is thus a significant challenge for them to find occasion to update and maintain preference cards manually, and hospital supply chain management suffers as a result. Hospitals seeking better OR efficiency and fewer inventory and supply chain issues must turn to technology for a solution.

Can’t We Just Use Our EMR?

Perhaps the most prevalent piece of software used in hospitals today is the Electronic Medical Records system, or EMR. EMR systems such as EPIC have revolutionized patient care in recent decades, and studies reveal that over 95% of hospitals now use EMR systems to manage patient records. When approached with the question of how to solve the preference cards problem, many hospital administrators are therefore naturally tempted to query, “why not use our EMR to manage preference cards?”

EMRs are undoubtedly essential for hospital operations. They reduce human error, make patient information transparent and easily accessible, and allow for better communication among medical staff. These functions increase a healthcare organization’s efficiency and ultimately improve patient care. EMRs can also give patients better insight into their treatment plans, and they provide a secure way to store patient data. Yet despite the clear benefits of an EMR system for today’s hospitals, EMR tools are not equipped to solve the preference cards problem.

1. The Core Focus Is Wrong

The first difficulty with the EMR as a preference card management (PCM) system is simply focus. An EMR houses digitized patient healthcare charts, replacing the paper charts of former eras. The core purpose of an EMR, therefore, is to record and maintain patient information so that a patient’s full record may be accessed easily any time a physician or patient needs to see it. Depending on the hospital's requirements, the EMR may have other functionalities, such as cloud storage, billing, and lab test transmission, and reporting capabilities that allow for some level of customization. Systems such as EPIC also have the ability to digitize preference cards, and OR staff can view and update preference card information in the system instead of on paper.

But EMR systems are not built for preference card management, and the expectation that an existing EMR system can be quickly or easily manipulated to effectively manage surgical preference cards is simply misguided. Far from enabling effective workflow management for the OR and the hospital’s supply chain, EMR platforms are optimized primarily to provide secure and accessible storage of medical records. While digitized preference cards are certainly preferable to paper cards, successful preference card management demands far more than digital information storage. The preference card data problem is a complex one, and the work necessary to build an effective system is challenging and expensive. It would be unrealistic, therefore, to expect an EMR to provide such a system when that is not its core focus.

2. EMR Systems Lack the Necessary Data

Research shows that successful preference card management can be a key to major savings at hospitals, as the cards are directly linked to how well a hospital manages its inventory. The extent to which preference cards are accurate and up to date has a significant effect on how much a hospital spends on surgical supplies. Inaccurate cards, in fact, regularly cost hospitals millions of dollars per year in wasted supplies. A successful PCM system, therefore, must focus foremost on identifying opportunities for cost savings and improving a hospital’s supply chain. In order to do so, it must have access to vital inventory and supply chain data in addition to the data collected from preference cards.

An EMR can help a doctor manage patient care from start to finish during a procedure, but as a PCM tool, it is lacking. EMRs are not built to identify areas of waste and find opportunities for standardization and improvement across an entire hospital. The only inventory data EMRs are privy to, in fact, is that which tells them what is currently stocked on OR shelves. They provide no insight around inventory in other parts of the hospital, and they may not account for inventory that is currently in circulation. In order to access comprehensive inventory data, integration with an ERP (enterprise resource planning) system or item master would be necessary.

3. Lack of User-Friendliness

Although EMR systems are built to reduce human error and improve management of patient records, they have a reputation for being time-consuming and difficult to use. They frequently increase the workload for physicians and nurses, who may spend twice as much time dealing with the EMR as they do caring for patients. Rather than streamlining the workload for physicians and nurses and cutting down on time spent on administrative tasks, EMRs may increase it due to poor organization and lack of user-friendliness. The excessive time spent in front of screens can be unbearably frustrating for OR staff, and it is directly linked to physician and nurse burnout.

The time of anyone who works in an operating room is valuable, and hospitals need their OR staff to spend as little time as possible performing data entry in front of a screen. A successful PCM system will enable nurses and physicians to spend minimal time in the platform so that they can spend more time with their patients.

4. No Functionality for Persistent Maintenance

Preference card clean-up is not a one-and-done activity. It requires frequent maintenance as procedures change and hospitals standardize and update their supply inventory. While EMR systems may allow nurses and physicians to make updates to digitized preference cards, they provide no guidance for how or when to do so. Other than notifying OR staff when a card has not been updated in a while, EMRs cannot recommend changes to cards or facilitate card updates in any way. Nor can they provide guidance around building a card based on best practices or industry standards.

In order to reduce busywork as much as possible, a successful PCM system must be able to gather and employ data from across all preference cards as well as inventory data to provide dynamic recommendations. This guidance should include proposals for standardization as well as cost savings, and analytics should help direct a hospital to add, remove, and update the quantity of items in its inventory. Preference card management is an ongoing exercise, and a PCM system must be equipped to enable and encourage persistent maintenance through data-driven recommendations.

An EMR system may be indispensable for hospitals today, but it does not have the functionalities that hospitals require to clean up and maintain their preference cards. Nor is it equipped to detect valuable opportunities for improving the hospital’s supply chain management. Rather than relying on their EMR systems, hospitals looking to leverage their preference cards to cut costs and improve OR efficiency should consider adopting robust PCM software to solve their surgical preference cards problem.