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40% of Physicians See More EHR Challenges than Benefits

Nearly two-thirds of primary care physicians say EHRs lead to improved care, but the EHR challenges still outweigh the potential benefits.

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Source: Thinkstock

By Elizabeth Snell

- Over half – 59 percent – of primary care physicians (PCPs) think that EHRs should be completely overhauled, with 40 percent stating that there are more EHR challenges than benefits, according to recent research from Stanford Medicine.

An online poll conducted by The Harris Poll gathered responses from over 500 PCPs, reviewing how the physicians felt about EHR use, physician EHR satisfaction, and the future of EHRs.

Two-thirds of respondents said they are somewhat satisfied with their current EHR system, but just 18 percent reported to being “very satisfied.”

EHRs are also detracting from professional satisfaction (54 percent of respondents) and clinical effectiveness (49 percent of respondents). Seventy-four percent of those surveyed added that EHRs have increased the total number of hours they work daily, while 71 percent claimed that EHRs greatly contribute to physician burnout.

The report also indicated that EHR use could detract from a physician’s ability to interact with patients.

“PCPs reported spending a disproportionate amount of time per visit interacting with EHR systems, and many feel that EHRs are competing with their patients for already limited time and attention,” Stanford Medicine said in a statement. “On average, over the course of a 20-minute in-person patient visit, PCPs reported spending 12 minutes interacting with the patient, and eight minutes interacting with the EHR system.”

“This does not include another 11 minutes of EHR interaction once the patient visit had concluded.”

EHRs are largely seen as a storage option instead of a clinical tool, according to the poll findings.

Data storage was the primary EHR value listed by physicians (44 percent), followed by disease prevention/management (3 percent), clinical decision support (3 percent), and patient engagement (2 percent). 

However, respondents also listed ways that EHR use can be improved to benefit both the provider and the patient.

Seventy-two percent of those polled said they would like an improved EHR user interface design to eliminate inefficiencies and reduce screen time, with 48 percent wanting to shift more EHR data entry to support staff.

Thirty-eight percent of respondents suggested that increasing highly-accurate voice recording technology that acts as a scribe during patient visits would be a good short-term improvement option.

Stanford University School of Medicine Dean Lloyd Minor, M.D. explained that EHR use has transformed the healthcare system but noted that providers are not necessarily wiser from utilizing the technology.

"Insights that could lead to better patient care or new medical discoveries remain buried within piles of disconnected data,” Minor said in a statement. “Moreover, EHR use has eroded professional satisfaction among physicians.”

“This national poll underscores what many physicians have felt for a while: their needs are not reflected enough in the design of these systems,” he continued. “Fixing the problem goes far beyond technology, and it will take many stakeholders working together to make EHRs more user-friendly and capable of achieving their true potential."

For long-term EHR improvements, approximately 70 percent of respondents said improving interoperability issues would be beneficial. Forty-three percent of PCPS suggested having improved predictive analytics to support disease diagnosis, prevention, and population health management, while 32 percent said integrating financial information into EHRs to help patients understand care costs would help.

A 2017 Pew Charitable Trusts report also showed that increased EHR use has led to clinical efficiency improvements and unanticipated safety problems.

A poorly-designed EHR interface can inhibit providers’ ability to quickly locate information and a difficult to navigate interface could impact clinicians’ productivity, the report explained.

“Important design principles include knowing what users need for a simple interface, removing complexity, using simple and clear terminology, emphasizing key elements, and using color effectively to draw users to important areas,” report authors wrote.

Pew did caution though that over customizing EHR systems could lead to problems as well. Some of the changes “may not have undergone rigorous testing by the care team or the product developer to detect potential safety concerns.”

Overall, Pew suggested that cross-industry collaboration, such as a national health IT safety collaborative, could help EHR developers, hospitals, and clinicians to ensure that EHR systems are optimized for patient care and overall usability.

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