Problems continue for EHRs, but whose problems are they?
Friday, September 30, 2016
Electronic health records have been one of healthcare's most innovative or divisive — depending on your personal point of view — technologies since the start of the modern, technological age.
They take up more of doctors' and practice administrators' time, create more technical trials, and may lead to physician burnout, according to a recent report by US News & World Report. Specifically, electronic health records "have helped fuel a national epidemic of burnout among doctors."
"The clerical burden associated with electronic health records has been a major contributing factor to physician burnout, with computerized physician order entry as the biggest source of frustration," says Dr. Tait Shanafelt, the lead author of a study on the issue and director of the Mayo Clinic Department of Medicine Program on Physician Well-Being.
Even the simplest tasks in the systems can be considered daunting, the research states — jobs that once took seconds now take minutes, for example.
As we've covered before, EHRs were supposed to bring unprecedented efficiency and streamline every administrative task. They were supposed to allow doctors and health systems to capture information, analyze it and then quickly exploit the results to cut costs and improve service — in short, to improve patient care and deliver better quality.
Perhaps that idea of EHRs has been oversold.
But now doctors and care providers have come to podium in an effort to make their lives easier with the technology, and some are now making adjustments to ease implementation, according to a qualitative study analyzing doctor perceptions of EHRs. These workarounds are attempts to make the technology easier to use, and to leverage the technology to improve their healthcare organizations. And the workarounds are working, reports suggest.
However, the workarounds, in most cases, are not shared or made public for others to use to benefit from their technology. This is an issue, perhaps to some, because a collective knowledge might make the system better for all parties. But is this is the problem of the physician, or is this more of an issue for the vendors to take up?
Tracy Porter, co-author of a recent EHR study and an assistant professor at Cleveland State University, notes in Crain's Cleveland Business: "There's a lot of good to EHRs, but if there's problems, I think we need to, as we move forward, learn from each other, expose those. I think the workarounds aren't a bad thing necessarily, but I think we can share with each other."
The study in question suggested the workarounds do help make the technology work for them, but again, these fixes are not being made public. But some, like the Cleveland Clinic and University Hospitals in Cleveland, each have processes in place to encourage providers to share these fixes.
"University Hospitals also has processes in place to find ways to improve the experience of using EHRs," according to Crain's. "A committee of physicians, administrators and IT specialists meets monthly to improve EHR processes and the product. Once a quarter, physician leaders meet with senior leadership of an EHR company to discuss ways to improve the product itself."
But, again, are these workarounds really the responsibility of the caregivers, or should they have the free right to make their technology best serve their organizations? EHRs may not be living up to their perceived expectations regarding efficiency and time savings, but when caregivers are strapped for time and burdened by technology, is there an intrinsic problem with making fixes to them to best meet their needs?
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