Doctors Aren't Luddites. But Their EHRs Are Broken

Jared Kaltwasser
OCTOBER 19, 2018
ehr burnout,physician burnout,ehr problems,hca news
Physicians say their EHRs are creating workflow burden.

Electronic health records (EHRs) have been billed as a way to make healthcare more efficient and transparent, but a new survey suggests one of the technology’s major contributions might be an increase in the rate of physician burnout.

Medical malpractice insurer the Doctors Company published its new “Future of Healthcare” survey, which probed more than 3,400 physicians, finding that a high percentage of physicians associate EHRs with frustration. They also say the technology is hurting the doctor-patient relationship.

>> READ: Fixing Physician Burnout Is More Than Just the Decent Thing to Do

Bill Fleming, MBA, chief operating officer at the Doctors Company, said earlier editions of the survey suggested physicians were apprehensive about the burden of EHR documentation.

“Now that more doctors have EHRs in place, written responses to our survey confirm that these anxieties were not misplaced,” he told Healthcare Analytics News™.

In fact, 61 percent of physicians in the new survey said EHRs negatively affect productivity and efficiency.

“Physicians’ frustration with EHR technology stems from the time spent after hours completing documentation, much of which is unnecessary or duplicative,” Fleming said. “The consensus of physicians is that time spent managing EHR documentation would be much better used in treating patients.”

One of the more than 2,000 physicians who provided written comments to the survey summed up the problem this way: “To ask a physician to function as a scribe is inefficient.”

To underscore his point, Fleming pointed to a July article in the Journal of the American Medical Association, by Robert M. Wachter, M.D., and Michael D. Howell, M.D., MPH, which argued physicians don’t often see the benefits of the EHR.

“Rates of physician self-reported burnout are high, partly because little useful intelligence is delivered back to physicians despite all their time spent performing data entry,” they wrote.

While many physicians are frustrated with the way their role is changing as a result of EHR technology, Fleming said they also feel the current software is insufficient.

“Physicians also expressed frustration with the selection of technology in the market, with one doctor observing that the technology is ‘poorly designed … cumbersome and user-unfriendly,’” he said.

But Fleming said it’s fair to assume EHR technology will improve over time and become more user-friendly.

“In the meantime, physicians and patients are stuck in a paradox that creates difficulties for both,” he said.

Doctors are also upset about the way in which EHRs can create a physical and figurative barrier between patients.

“When a doctor types and looks at a computer screen while having critical, sensitive discussions with patients, it can feel impersonal and detached,” he said.

In the survey, 54 percent of physicians said EHRs harm the doctor-patient relationship.

Fleming quoted another respondent, who said, “Doctors can’t type and have good patient observation and attention simultaneously.”

Having to split eye contact between a screen and the patient, Fleming said, is “clearly an obstacle to delivering the highest possible quality of care.”

Concerns like that, rather than curmudgeonly opposition to change, are driving physician frustration with EHRs. For one thing, demographically, physicians tend to be early adopters of technology.

“While, undoubtedly, some physicians were reluctant to embrace EHRs early on, increased adoption and familiarity has not alleviated concerns related to their perceived negative impact on the doctor-patient relationship,” he said. “It would be wrong to dismiss these concerned physicians as Luddites.”

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