- Although the technology has been widely implemented, physician EHR use raises significant clinical workflow issues. Survey after survey point to some of the fundamental problems physicians have with their EHRs and the ways in which they often block productivity and their ability to deliver quality patient care.
Between technology glitches or limitations and issues integrating EHRs seamlessly into clinical workflows, these tools have presented at least a portion of the provider population with their handful of roadblocks.
Limited EHR interoperability
EHR interoperability is a notable buzzword in the healthcare IT industry. Now that EHR adoption has reached over 90 percent industry-wide, experts have shifted their focus to getting different systems to work well together.
This focus is critical because EHRs have notoriously limited interoperability. While the industry is making some progress through collaboratives such as the CommonWell Health Alliance and through innovations such as FHIR, research shows that many of these tools can’t easily exchange health data with one another.
This seriously hinders patient care. When a patient receives treatment from a different provider – whether that be in an emergency situation or due to visiting a specialist – it is important for that new provider to have access to that patient’s health history. As the industry stands now, that capability is limited.
EHRs likely aren’t going anywhere, which means that developers will need to continue to work toward interoperability. Considering interoperability requirements under stage 3 meaningful use and MACRA, providers will need this functionality to continue integrating EHRs into their clinical workflows.
Handling burdensome requirements
In its 2016 EHR Report, Medscape found that most providers saw a slowdown in clinical workflow following EHR implementation. Across all age groups, at least 48 percent of patients saw these kinds of problems.
This is likely due to reportedly burdensome EHR reporting requirements. The EHR Incentive Program out of the Centers for Medicare & Medicaid Services (CMS) are one example of these complex and often difficult reporting guidelines.
Because providers must focus on certain standards such as adequate patient engagement or documenting measures, they cannot focus on the task at hand. Likewise, providers often report being inundated with alerts and reminders, which may slow them down when trying to complete a specific task.
Lacking EHR usability
Also stunting provider productivity and clinical workflow is lacking EHR usability. Providers often report that these technologies are not intuitive or navigable, and therefore slow them down when they are attempting to complete a task.
Research shows that lacking usability is a primary pain point for most providers. Last year, a Frost & Sulllivan report highlighted EHR usability as the primary concern for healthcare chief information officers.
Heading into the final stages of meaningful use and the implementation of MACRA, more and more providers are likewise concerned with EHR usability. In order to perform successfully in either of these programs, providers will ideally need to be comfortable with their EHRs and be able to navigate them seamlessly and efficiently.
Reducing face-time with patients
Medscape’s EHR Report also highlighted a substantial issue with EHR use: hindered interactions between patients and providers. With a computer screen separating the patient and the provider and the many tasks the provider must perform, these tools can often get in the way of blossoming patient-provider relationships.
In the study, 57 percent of respondents said EHR use limited their face-time with patients and 50 percent said it limited the total number of patients they could see per day.
Other research has shown that providers must be careful about how they integrate the EHR into their clinical workflows and patient interactions.
One 2015 study found that providers who limited their screen time elicited better patient satisfaction reviews. Those who used the EHR longer during appointments elicited lower patient satisfaction scores.
However, striking this balance is difficult. As noted above, EHRs present many hurdles. Providers must attest to federal reporting programs, they must navigate difficult-to-use screens, and must mitigate numerous alerts and reminders. In balancing all of that, it is often difficult for providers to keep the focus on the patient.
Going forward, it may be important for providers and EHR developers to work together to better understand how to integrate EHRs into clinical workflows and mitigate these issues that hinder providers.