Electronic Health Records

Adoption & Implementation News

What causes physicians to become dissatisfied with EHRs?

By Kyle Murphy, PhD

- In the health IT community, few things generate more discussion than some good old-fashioned EHR backlash. When it comes to lambasting the adoption of EHR technology, many critics emerge and are vocal about their negative experiences and who’s to blame.

The comments in response to op-ed by gastroenterologist Michael Jones, MD, were anything but unexpected. Jones’s opinion that EHR systems were a detriment to physician-patient relationships was echoed by a number of readers.

While venting frustration could prove cathartic, it doesn’t necessarily provide a solution to the problem. A closer inspection of comments from members of the LinkedIn community reveals a common set of problems with current EHR systems that if addressed could do wonders for improving physician EHR satisfaction.

Here’s a rundown of the most common causes:

First and foremost, the EHR system is designed based on clinical needs. Instead, most “were designed to attend to billing needs and have very little in the way of clinical features/functions,” wrote one commenter. This emphasis on satisfying billing needs manifested itself in the physician focusing too “much on documentation and too little on physical interactions.

“Now the doctor comes in opens up a laptop on electronic notepad and starts typing as you respond to questions,” said another commenter. “The visits are shorter and I guess they consider them more ‘efficient’ but there is something missing.”

Second, current EHR systems lack the ability to exchange health information possible. “Until we get real data exchange from provider to provider, and provider to patient as well the ability to really use the data to enhance patient care, the benefit of EHRs will not be realized. For now it’s a burden,” commented another.

In attributing this lack of interoperability and health information exchange to a common cause, one commenter pointed to “the burden that is being imposed by MU legislation.” That is, the direction of meaningful use has placed emphasis on certain areas that some feel are not relevant enough to quality care.

Third is the matter of training, which involves a good amount of planning if physicians are going to buy in. “The only way to get here is training and practice, difficult at best on a physician’s schedule,” observed a commenter. If physicians are unwilling or unable to put in the time to build familiarity with the EHR system, they cannot be expected to reach a level of comfort and proficiency with it.

Lastly, having a poor working relationship with an EHR vendor could easily spoil the EHR adoption process. “If you cannot call up a vendor and let them hand over the controls so that you can build a small representative workflow of your choice and have it rolled out for “piano-playing” in 1/2 an hour, keep looking,” another argued.

By no means is this a complete list of the causes of physician EHR dissatisfied or proper justification for those galvanizing support around #EHRbacklash. However, they are opportunities for healthcare leaders to find solutions that improve the situation and hopefully attend to the needs of physicians and their patients more directly.

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