The secret weapon in optimizing electronic health record workflows

If you ask anyone working in healthcare IT about electronic health record (EHR) workflows, you’ll likely get one of two reactions: a confident shrug or a defeated sigh. But as with most things in healthcare, the reality usually sits somewhere in the messy middle.

In my 13 years of experience with PaperCut, I often see healthcare IT teams buying into the myth that it’s possible to streamline EHR through one magical system that will cover absolutely everything a hospital needs. Not only would such an application come with incredible complexity, but the costs would be astronomical – both the upfront investment and ongoing operating expenses.

My advice? Stop chasing a state of perfection that doesn’t exist. The secret weapon in optimizing EHR workflows isn’t uniformity, but interoperability between people, systems, and processes.

Hidden bottlenecks in hospital workflows

From a distance, EHR systems might seem like a smooth, neat flow of information from patients to clinicians. But viewed up close, these workflows are where people and processes often collide in the real world. They span departments, devices, and roles. And they’re not just digital but physical too, involving printers, fax machines, card readers, and a whole lot of legacy infrastructure.

The idea that EHR systems live in the cloud is entirely false – and each piece of technology is a potential point of failure. Even something as simple as a card reader, of which there are literally thousands scattered across a hospital, requires hardware and software to function. It also needs applications that can understand the data it receives from them. Add in multiple different operating systems, and you can start to see how quickly the complexity balloons. 

But even if you have the most advanced digital record system in the world, the weak link will always be the humans who operate it. The biggest issue I come up against is competing priorities within and across departments. For example, consider a nurse whose main focus is, as it should be, patient care. Then imagine they need to adjust the EHR for wound care documentation, which is just one function within the entire system.

But when they put in a change request to address a specific need of their department, they’re not necessarily thinking about the implications of that change for authentication, for remote access, for printing, for auditability and compliance. This siloed approach means that one person removing friction from their own process may just be pushing that friction into someone else’s workflow. Now another person has to go through additional steps that didn’t exist before. So the problem may not be technical glitches per se, but a lack of coordination; each department is solving for their own problems but inadvertently creating new ones elsewhere.

And that’s before you’ve even reached the printer at the end point of almost every EHR workflow – whether it’s a prescription, referral, or treatment plan – which is one of the most complex machines in the hospital. One paper jam or misrouted print job can grind the entire process to a halt.

What optimization actually looks like

First, let me tell you what optimization doesn’t look like, just by considering something as seemingly mundane as faxing. At a large hospital in Melbourne, a central IT team manages faxing across all facilities. However, each campus uses it differently, so you end up with licensing issues, failed integrations with print management systems, and a lot of wasted time on tech support. 

On the flip side, the NHS in the UK is probably the gold standard of healthcare tech. Through a combination of government mandates – like ‘Axe the Fax’ to replace legacy hardware with digital workflows – and groundbreaking platforms like Patienter, the entire system has been making huge strides in modernization. Sometimes you need that regulatory pressure, added to healthy market competition between a lot of different vendors, to become really forward-thinking in this space.

So when systems talk to each other – when they’re built to integrate with, not exclude other systems – a hospital or clinic can unlock serious efficiency. But that’s a huge shift for some vendors, because it means recognizing that you’re only part of this bigger picture. 

A truly optimized workflow may be a unicorn, but we’ve got glimpses of it. Rather than a single, all-encompassing EHR system that does everything, it’s one where everything works together. You can see this in an application like Epic, which is the market leader in medical records for a reason. In our experience, speaking primarily from the print and document output space, they create room for vendors to build into their system.

The overlooked infrastructure holding it all together

In big, complex ecosystems like this, print is just one piece of the puzzle, but it’s a very important one, not because print is flashy but because it touches every department. There is no such thing as a paperless office in healthcare. Print is the invisible thread connecting electronic health records to actual patient care.

And here again, interoperability is the key ingredient to optimization. In print management, we work directly with Epic to align roadmaps and solve problems together. Meanwhile, they’re growing their vendor services to allow independent players to plug in to the platform.

So my advice is, instead of hunting for a silver bullet, focus on systems that play well with others. There’ll always be new applications, new operating systems, new regulations. Build processes that can anticipate that and adapt to change.

There’s never a finish line in optimizing EHR workflows. It’s like a relay race where everyone is running at a different speed, but they’re all trying to hit that end goal of improving patient care. It’s about recognizing that optimization is a journey, not a destination, and every piece of your infrastructure plays a part – from card readers to software to printers. That’s why interoperability is the foundation of a sustainable and scalable EHR system.