Rallying Physicians to Fix EHRs
There’s a long history of physician dissatisfaction with clinical information systems. Next week, the AMA brings its campaign to collect physicians’ personal testimony to PatientKeeper’s neighborhood, when it holds its second “town hall” meeting, this time at the Massachusetts Medical Society’s headquarters (which happens to be right next door to ours).
Physician frustration stems from the fact that, compared to the paper records that most doctors “grew up” using, EHRs are productivity and efficiency inhibitors – the exact opposite of what computerization is supposed to do. Here are five common issues that hospital CIOs should be sensitive to:
1) EHRs impose an unfamiliar workflow on physicians, dictated not by what the physician knows about treating patients and has been doing for years, but rather by the processes that exist deep inside the hospital.
2) EHRs typically require extensive classroom training.
3) Getting all the information needed about a particular patient is cumbersome because the data may live in multiple systems/modules, and the systems are structured in a process-centric way rather than a patient-centric way.
4) Physicians experience alert fatigue from computerized physician order entry (CPOE) systems because many alerts are unnecessary and/or irrelevant, and typically fail to take into account the physician’s specialty, knowledge, and patient situation.
5) In many computer systems, physicians are almost encouraged to dump large amounts of clinical information into their notes, providing little value for the next clinician reading it. (Whereas in the paper world, physicians are careful editors and include only the most relevant results in their notes.) As a result, physicians are spending more time sifting through lengthy clinical notes trying to discern the vital nuggets of information necessary to inform the care they’ll deliver.
For the sake of physicians’ productivity and efficiency – not to mention improving patient care – these and other impediments to using hospital EHRs demand attention. After all, physicians are by far the most expensive and limited resource in the healthcare system. IT leaders have an obligation to help them do and be their best.