EHRs Stress Physicians
By Katie Wike, contributing writer
Study shows doctors spend more time on documentation since the implementation of EHR systems
“I found that our EHR was slowing me up a lot in the clinic,” Dr. Alan J. Bank of United Heart and Vascular Clinic in St. Paul, MN told EHR Intelligence. “It was cumbersome, and I wasn’t enjoying working in the clinic very much, because I was just doing too much paperwork and too much typing, just filling out all these forms and scheduling things, and doing everything on the computer. I just wasn’t enjoying the clinical practice.
“One of my colleagues was going to cut back to 80% time because she wasn’t getting home to see her kids,” said Bank. “Another would go home and eat dinner with his family, and then he’d finish his notes for two hours at home. Another was staying until 8 or 9 at night, and was always behind when seeing patients.”
Bank’s frustration associated with the use of electronic health records isn’t isolated according to EHR Intelligence, which writes. “EHRs have been different from the beginning, and the toll this supposedly revolutionary technology has taken on the psyches and daily experience of physicians is not exactly a secret. Healthcare has started to hammer home the importance of treating patients as whole people, not just as diseases, but physicians seem to be exempt from this holistic view. Are we ignoring the emotional impact of EHRs? Are we attributing the complaints to grumpy stick-in-the-mud old-timers instead of treating burnout as a symptom of a larger epidemic poised to crush the system? How can we change our attitudes while focusing on making health IT work?”
EHR Intelligence notes, “Five minutes of clicking here, ten minutes of typing there, and that’s one less patient per day every physician gets to see. Research from the American Journal of Emergency Medicine shows that ED physicians spend 44 percent of their time on EHR work, and only 28 percent of their day seeing patients. Four thousand mouse clicks during a ten hour shift sounds a lot more like a day spent playing Solitaire than the busy immediacy of critically ill patients in an emergency situation.”
A study reported on by Family Practice News showed in two California educational medical institutes, researchers found physicians spent an average of 16 more minutes inputting data to an EHR system than they spent on documentation before the electronic records were implemented. Dr. Maisara Rahman, department of family medicine at Loma Linda University and an attending physician in the department of family medicine at RCRMC, told Family Practice News, “We have learned about how electronic health records are going to improve our patient care and our efficiency in the clinic but not a lot of studies have explored how the implementation of an electronic health record at academic centers is going to impact resident education.”
Rahman concluded, "It is imperative that these institutions customize and implement EHR systems that enhance and support resident education. EHR has a unique potential to become an educational tool if it is customized and developed for resident education. The traditional teaching methods in ambulatory clinics will need to adapt to a more innovative, technology-enhanced learning environment. Further research is needed to identify improved EHR systems that optimize and enhance residents’ education."