Electronic Health Records

Adoption & Implementation News

EHRs are “a source of stress” for physicians, AMA says

By Jennifer Bresnick

Physicians who feel like they can’t deliver quality care to patients have low levels of job satisfaction, and EHRs are the biggest obstacle to providing the best possible services, argues the American Medical Association (AMA) and the RAND Corporation in a new report.  Cumbersome workflows and confusing interfaces are a significant source of stress for providers who want to focus on their patients, contributing to high levels of disgruntlement that may serve as an early warning of deeper problems in the healthcare system.

“Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care,” said Dr. Mark Friedberg, the study’s lead author and a natural scientist at RAND, a nonprofit research organization. “Physicians believe in the benefits of electronic health records, and most do not want to go back to paper charts.  But at the same time, they report that electronic systems are deeply problematic in several ways. Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients.”

Backlash against poorly designed EHR systems and complex federal mandates is not a new phenomenon.  An overall feeling of skepticism and frustration with electronic charts has been well documented since the EHR Incentive Programs brought health IT into the majority of hospitals and physician offices.  A recent survey found that physicians are losing an average of 48 minutes per day to their laptops, while a Medical Economics poll from February states that 67% of providers are unhappy with their EHR systems’ functionality, and a similar number reported financial losses after implementing the technology.

According to the AMA and RAND, providers have been coping with their frustrations in a variety of ways, including finding creative ways to complete clinical documentation or hiring extra staff members such as scribes to help them meet the demands on their time.  Physicians who have more control over their workflow and the structure of their administrative responsibilities expressed higher levels of satisfaction with their work, while a sense of fairness, equity, and communication with peers and leaders also helped to raise morale.  While physicians are generally satisfied with their income levels, they strongly desire to work to the highest level of their training without being required to perform tasks that could be relegated to lower-level members of staff, such as the copious amounts of data entry often blamed on EHRs.

“EHR usability represents a unique and vexing challenge to physician professional satisfaction,” the report says.  “Few other service industries are exposed to universal and substantial incentives to adopt such a specific, highly regulated form of technology, one that our findings suggest has not yet matured. Nearly all physicians we interviewed say the benefits of EHRs and believed in the ‘promise of EHRs.’ On the other hand, physicians cannot buy, install, and use a promise to help them deliver patient care.”

Better usability of EHR systems should be “an industrywide priority,” the report argues, and should focus on creating technology systems that reduce regulatory and administrative burdens instead of creating them.  Physicians who feel overwhelmed by their EHR systems may not be delivering optimal levels of quality care, which has a serious impact on patient safety and outcomes.  Improving the EHR user experience to keep physicians working at the best of their abilities may be a crucial factor for ensuring the long-term success of the rapidly evolving healthcare industry.




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