Physicians using electronic health records often still resort to the paper workarounds, according to a study published recently in Applied Clinical Informatics. While electronic health records (EHRs) have potential to facilitate reliable communication and followup of test results, limitations with functionality remain.

EHR workarounds lead to inefficiencies and default the actual benefits of the systems and the reasons for their implementation in the first place. Also, workarounds can lead to patient safety concerns and "signify indications as to how to build better EHR systems that meet provider needs."

According to the authors of the study, of the 2,554 survey respondents, 43 percent reported using workarounds related to test results management and, of these, 93 percent described the type of workaround they were using. Of the workarounds reported, 70 percent said they used paper-based methods, and 22 percent used a combination of paper- and computer-based workarounds, such as e-calendars, to follow up.

Thus, primary care practitioners said they needed limited administrative support to help them notify patients of test results. Respondents said the three primary reasons for workarounds were as a memory aid, for improved efficiency and for facilitating internal and external care coordination.

So, according to the authors, workarounds to manage EHR-based test results are common "and their use results from unmet provider information management needs."

EHRs can improve patient care, but they still suffer from design problems can cause inaccuracies and make it much harder to track information. The researchers examined data from primary care physicians in the Department of Veterans Affairs system and reviewed workarounds in test results management.

According to FierceHealthcare, "Workarounds improved efficiency because the EHRs generated an overload of alerts, reminders and other information. Paper was used to coordinate care because other providers, such as non-VA labs, used it to report test results."

Also, according to the study, EHRs might — it's probably a long shot — be redesigned to allow for electronic self-reminders, reduction of administrative burdens, and better support for notification processing.

"Paper-based workarounds are common," the researchers said. "The main reasons for use of workarounds are to improve efficiency, trigger memory and improve care coordination. Future EHRs and their respective work systems around them will need to evolve to meet these needs."