The Lie of the Default EHR: Why You Still Have Work After the Visit
Your EHR can be your biggest hurdle or your strongest ally.
If you feel like your electronic health record (EHR) is clunky, slow, and full of generic templates that force you to work late, you are not alone. EHR inefficiencies are a notorious source of unpaid after-hours work, effectively giving you a pay cut by making you work a 60-hour job on a 40-hour salary.
The good news is that you are not powerless. Optimizing your EHR is the front-loaded effort that allows you to automate repetitive tasks and save countless minutes every day.
🛑 Contrarian Take: You're Wasting Time on Repetitive Work Your EHR Should Be Doing for You.
A generic or poorly configured EHR slows you down, leading to endless clicking, searching, and manual typing. This pushes documentation and order entry into your personal time.
The Solution: Customizing and Automating
EHR optimization is an investment that pays you back in saved hours every week. It allows you to document with clarity and speed within your regular work hours.
1. Build an Asset Library (Dot Phrases and Templates)
Instead of typing the same phrases or documentation blocks repeatedly, customize your EHR to instantly deploy text:
SOAP Note Templates: Create a Foundation SOAP template and reusable building blocks that are structured, problem-focused, and reflect your clinical reasoning. Download a free version of my SOAP template here.
Dot Phrases/Macros: Use shortcuts (e.g., .fuhtn or .dmplan) to drop entire, comprehensive paragraphs of patient counseling or HPI details. The SignTheChart Store has loads of diagnosis-specific dot phrases to get you started
2. Master One-Click Ordering (Order Sets)
Order Sets are pre-built collections of labs, imaging, referrals, and treatments for specific conditions (e.g., Hypertension, Diabetes).
Benefit: They eliminate repetitive clicking, reduce cognitive load, and ensure you don't miss important tests or screenings, saving minutes on every visit.
Example: A Diabetes Order Set can include A1C, fasting glucose, lipid panel, Metformin, and referrals to podiatry/nutrition—all in one click.
3. Simplify Navigation and Naming
You should spend less time clicking and searching.
Shortcuts: Use keyboard shortcuts (like F2 in Epic or F10 in eClinicalWorks) and speed buttons to move through the chart faster.
Smart Naming: Use a consistent naming convention (e.g., .[YourInitials]_DM_HPI) to pull up your blocks instantly, rather than scrolling through a huge list of shared phrases.
🔒 Protect Your Investment: The Two Sets Rule
Because all that meticulous work could be lost overnight if you change jobs or your employer switches EHRs, you must always create two copies of your EHR assets.
Internal Storage: The templates, dot phrases, and order sets saved within your EHR.
External Backup: A copy of all the expanded text and their shortcuts saved on cloud storage (Google Drive/Dropbox) or a thumb drive.
💡 Solution: Master Your EHR with Chart Smart Mastery
EHR optimization is the front-loaded work that pays you back in time every day. Building your template library, order sets, and dot phrase collection is an investment. The hour you spend building a comprehensive diabetes order set today is 90 seconds per patient every time you use it.
Chart Smart Mastery covers EHR optimization in full, including how to build your asset library, structure your SOAP templates, design condition-specific order sets, and back everything up externally so you do not lose it when you change jobs. It is the most time-intensive part of the course and the one with the most immediate daily return.
Want to see how these tips translate into speed?
Read our related articles:
Why Smart Lab Ordering is the Secret to Reducing Your Workload
NP Resident Cuts Visit Time by 50% with One Charting Hack.
The Adult Primary Care Annual Physical Chart Smart Kit Bundle is a comprehensive and time-saving resource designed for primary care providers. This bundle includes six specialized Chart Smart Kits tailored for conducting annual preventive care visits for male and female patients aged 18-39, 40-64, and 65 and older. With the incorporation of the latest USPSTF (U.S. Preventive Services Task Force) recommendations and other essential preventive care guidelines, this bundle streamlines the process of providing high-quality care while reducing administrative burden.
