- A recent study by Pelland et al. found that while EHR use may reduce medical errors, the technology is also shown to complicate the patient-provider relationship.
Researchers at Brown University performed a qualitative analysis of comments submitted to a 2014 Rhode Island Health Information Technology survey to gain insight into physicians’ personal experiences with EHR systems.
Both office- and hospital-based physicians in Rhode Island submitted responses describing their perceptions of the impact of EHR technology on patient-physician interactions. Responses from hospital-based physicians were measured against the opinions of office-based physicians for contrast.
While both hospital-based physicians and office-based physicians voiced concerns regarding the effect of EHRs on patient-provider interactions, the two demographics cited different reasons for their frustrations.
“We noted the same five themes among office-based physicians, but the rank order of the top two responses differed by setting: hospital-based physicians commented most frequently that they spend less time with patients because they have to spend more time on computers; office-based physicians commented most frequently on EHRs worsening the quality of their interactions and relationships with patients,” wrote researchers.
These differences are partially attributable to the contrasting environments of the two groups of respondents.
“The difference in frequency of the top two themes likely reflects fundamental differences in how inpatient and outpatient physicians work, with hospital-based physicians frequently using computers situated outside of patient rooms and office-based physicians increasingly bringing laptops into exam rooms,” reasoned authors.
As part of the survey, respondents also offered suggestions to mitigate the overall negative effect EHRs have had on patient-provider interactions. However, these strategies often augment a physician’s daily workload.
“Both groups described strategies to adapt to an increasing documentation burden, with some hospital-based physicians describing the use of problem lists and lab results to feel more prepared for the clinical encounter, and office-based physicians choosing to work additional hours at the office or at home.”
Despite the negative impact the technology has had some physician’s perceptions of the patient-provider relationship, the study also yielded positive feedback surrounding improved information access and EHR use in patient care.
Ultimately, the negative impact of EHR use appears to outweigh the benefits of the technology in the eyes of most hospital-based physicians.
“Although hospital-based physicians report benefits ranging from better information access to improved patient education and communication, unintended negative consequences are more frequent themes,” stated researchers. “When comparing themes across settings, we note that hospital-based physicians more frequently comment on the use of EHRs to feel more prepared for the clinical encounter, while office-based physicians more frequently comment on alteration of workflow and the depersonalization of relationships.”
Researchers hope findings from the study will be utilized in the future to modify the way physicians interact with EHRs during patient visits.
“Our findings can be used to shape interventions to improve how EHRs are used in inpatient settings and to tailor those interventions to specific specialties, with the end-goal of improving both physician satisfaction and patient experience,” they concluded.
This study adds to the cacophony of conflicting physician opinions regarding EHR use, adoption, and implementation.
Two recent physician op-eds offered insight into the variant minds of physicians practicing in today’s health IT environment.
While physicians at a Canadian general hospital cited several improvements in clinical efficiency and patient care delivery after a successful Cerner implementation, an American physician stated EHRs are a failed experiment only benefitting government entities and corporations.
With EHR adoption increasing at hospitals nationwide, the technology will likely persist as a divisive issue among users.