my inbox is full, the emr crashed, and the journals are piled high: efficiency in 2015 kenan...

My Inbox is full, the EMR crashed, and the journals are piled high: Efficiency in 2015

Kenan Omurtag, MDAssistant Professor, REI

Reproductive Endocrinology and Infertility

No Financial Disclosures


Objectives• Define the term Knowledge worker • Review tips and downloads to become “work/life-hackers”

• Work Management:• Email • EMR/Patient Flow• Literature• Boards• Collaboration


Knowledge Workers (K.W.) & Professionals• “think for a living”• TIME AND ATTENTION ARE FINITE

• Interruptions are Abundant• Colleagues stop by to discuss work/social stuff• Scheduled and unscheduled meetings• Constant stream of electronic communication

• Emails tweets, facebook, IM, texts, etc

• Patient Care Responsibilities


INFORMATION OVERLOAD!• Costs US economy 900B/year

• Unnecessary interruptions and resultant recovery time

• Unnecessary Interruptions + recovery time = 30% day

• Recovery time = 20 x (duration of interruption)• 30 second interruption = 5 minutes recovery time

• Interruptions are necessary for KWs

Intel Corporation Case Study 2009


Work Management


COVEY MATRIX

“What is important is seldom urgent”

“What is urgent is seldom important”

Urgent Non Urgent

IMPORTANT CRISESNECESSITYMANAGE

GOALS & PLANNINGQUALITY & PERSONAL LEADERSHIPFOCUS

NOT IMPORTANT INTERRUPTIONSDECEPTIONUSE CAUTION

DISTRACTIONSWASTEAVOID


2012-2013 for me• Finished fellowship

• Board exam and thesis

• Became a full time clinical attending• Built a house• Became a father with another child on the way• And my wife is a full time anesthesiologist


Formal End of Hard Skill Training


Work Management• Email management


Email- “Hacking”“Everyone has an online blog post or guide about how to best

manage email, but few, if any, are written with the unique interruptions of the healthcare professional’s day in mind…

until now”- Kenan Omurtag, MD


My (old) Email Habits/Philosophy• Valued rapid response

• I would respond immediately, even if immediate response not required.

• Check upon arrival• Notifications enabled on phone• Outlook open• Deleted unread immediately

• One professional inbox (Outlook)• No Inbox folders, no rules

• Addressed multiple topics in one email• Cognizant of recipients and CC etiquette• Never wrote what I couldn’t say to someone in person


My (old) Email Habits/Philosophy


Email Management – (new) philosophy• New demands require adoption of new, Good habits

• Clarity• Craft effective messages

• Concision• Limited characters forces you to craft better messages

• 5 sentences• Focus on one topic!

• Actionable• If you don’t know the messages purposes don’t send it

• Relevance• Stay consistent with the subject

• Easier to search later


E-Mail Management - Don’t waste motions• MINIMIZE Constant Inbox monitoring

• You wont get anything done – Kills productivity• 15 minute minimum• Disable notifications!!!• Answering in the am?

• Sort

• Batch Process the email• Delete• Mark as unread• Answer


Email Management - Misc• Decrease your Email Response Time

• Valuable soft skill• Trainees appreciate it • “GTD” & the “2 minute rule”• Avoid becoming an “unreliable email-responder”

• “Going strong to the Keyboard”• Keep combustible topics offline

• Commit to a routine• Schedule face-to-face discussion


CASE STUDY• 1 week• Changed email habits with goal to achieve Inbox ZERO at

the end of the day while free-ing up my time


EMR/Patient Note Management


EMR management• Our workflow mirrors those of office practice physicians

• Quicker • Concise

• Use your own tablet or laptop so the EMR is “always on”• Minimizing the 5 minutes it takes to find computer and log in and boot• Remote desktop options• May foster earlier note completion

• Delegate prior to visit if time/staffing allows• Whoever reviews outside records should record them into the EMR so

that the outside records are only reviewed once.


EMR management• Patient Note Tips• Learned in Residency- demands on your time will alter your

clinical workflow• Construct Assess/Plan with intent on it being read quickly and FIRST to

any of your partners• Buzz words• Match Diagnostic codes as best as possible• Summarizes all issues so colleague (and you) can understand

what is next• Finish notes before leaving for the day

• Electronic charge entry might be required in many settings• Minimizes the chance of missing charge entry


Case List Management• Record all procedures in real time: ETs, Egg retrieval,

laparoscopy, hysteroscopy, laparotomy for better case list management• Cloud Storage solution (Drive, Box)

• Allows for input anywhere there is computer• Mobile input• Potential dataset for retrospective cohort study

DEMO

http://www.google.com/drive


Literature Management


Reference Management Solutions• Freemium (mainstream)

• EndNote• Mendeley• Papers

• Free• Bibus – if you are into opensource• Zotero – Browser add on• Google Drive

DEMO


QUESTIONS

my inbox is full, the emr crashed, and the journals are piled high: efficiency in 2015 kenan...

Documents

infertility slide

reproductive endocrinology

md slide

rei slide

person slide

work management slide

time anesthesiologist

infertility knowledge