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Why Patients Should Care How their Doctors Feel About EHRs

A recent survey of physicians about their experience using EHR systems found that over one-third of respondents claimed that using the hospital’s system negatively affected their productivity.

A recent survey of physicians about their experience using hospital electronic health records (EHR) systems found that over one-third of respondents claimed that using the hospital’s EHR system negatively affected their efficiency and productivity. The same percentage said using an EHR detracted from the amount of time they spent with patients.

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So here’s a case of what’s bad for the goose is bad for the gander. Physicians and patients have a common interest in seeing improvements to hospital EHRs. Of course, they can’t make those improvements themselves. Physicians (at least most that I know) are not software programmers, so they’re not going to write the code to create a better EHR user experience. But patients and physicians can and should advocate for change.

Here are a few items on a physician’s list of EHR issues:

  1. The workflow imposed by hospital EHRs is unfamiliar to physicians; it is dictated not by what the physician knows about treating patients and has been doing for years, but rather by the processes that exist deep inside the hospital. This is a side effect of trying to support physicians’ workflow using a computer system designed to run a hospital.
  2. Because the typical EHR implementation involves not just educating a physician to execute their workflows using a computer but also forcing them to adopt new workflows, hospital EHRs require extensive classroom training that often takes physicians away from their patients for days.
  3. Physicians waste a lot of time clicking around the hospital EHR to find all the information they need about a particular patient. That’s because the data may live in multiple systems/modules, and the systems are structured in a process-centric way rather than a patient-centric way.
  4. Alert fatigue – a condition that occurs when there are so many alerts that physicians no longer pay attention to them – is rampant. Alerts issued by computerized physician order entry (CPOE) systems are a case in point. Many alerts are unnecessary and/or irrelevant, and they typically fail to take into account the physician’s specialty, knowledge, and patient situation.
  5. Physicians’ clinical notes are increasingly cluttered. In many computer systems, physicians are almost encouraged to dump large amounts of clinical information into their notes, providing little value for the next clinician reading the note.   As a result, physicians are spending more time sifting through lengthy clinical notes trying to discern the vital nuggets of information necessary to inform the care they’ll deliver to their patients during that shift that day.

These and other impediments to using hospital EHRs demand attention because physicians are by far the most expensive and limited resource in the healthcare system. 

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Fortunately, solutions exist to all five of the common EHR problems described above. Unfortunately, at many hospitals, those solutions have not been implemented. The result has been mounting physician frustration and lost productivity – and sometimes, whether patients realize it or not, slightly less time and attention from their doctor.

View an infographic about EHRs from a physician’s perspective – “The Way It Is vs. The Way It Should Be”.

Donald M. Burt, MD, is Chief Medical Officer at PatientKeeper, Inc. Before he joined PatientKeeper in 2007, Dr. Burt served as President of Berkshire Faculty Services, the multispecialty physician practice group affiliated with Berkshire Health Systems; Vice President, McKesson Corporation; and Vice President and Medical Director of Health New England, a provider-owner HMO.

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