From a decrease in time spent on face-to-face interactions with patients to extensive documentation requirements for clinical notes, EHRs have drummed up varying frustrations among healthcare professionals.
Here, four clinical IT leaders from hospitals and health systems across the country share what aspects of the EHR they think frustrate the clinicians at their organizations the most.
Editor's Note: Responses have been lightly edited for clarity and length.
Question: What do you find frustrates your clinicians most about the EHR?
Richard Paula, MD, CMIO at Shriners Hospitals for Children (Tampa, Fla.): The failure to fulfill the promise. Technology promises to improve our lives, to make our lives easier, more convenient and more fun. The modern EHR has done none of this; it has made our lives worse as physicians. It has taken time away from our interactions with our patients and time away from our families.
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Peter Schuyler Greene, MD, CMIO at Johns Hopkins Medicine (Baltimore): Efficiency is really at the heart of what troubles us most. Clinicians really want the EHR to make their work easier. Current EHRs take up too much of their time and pull them away from face-to-face time with patients and care teams. This impacts work-life balance. Another frustration is that EHR notes are efficient to create but often hard to read because of macros and copying functions and practices. We really need to revisit the gap between notes that people create using tools that the EHR has versus what they would really like to read.
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Peter Marks, PhD, vice president and CIO at WakeMed Health and Hospitals (Raleigh, N.C.): Effective adoption of any information system generally comes down to two key measures: ease of use and usefulness. Customers who use information systems in any function work best when both areas are strong. They will still use the system if one area is strong, but if both areas are low performing, frustration and struggle will follow.
EHRs are constantly increasing functionality and integration to make systems both easy to use and useful from a provider perspective. While these functions are maturing among EHR vendors, there will always be room for improvement. We work with our staff to focus on optimizing workflow and training for providers. Thankfully, the measures for both perceived ease of use and usefulness are trending up at WakeMed, which only happens when everyone works together to improve patient care.
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Jeffrey Belden, MD, a family physician at University of Missouri Health Care and medical director of interoperability at the Tiger Institute (Columbia): The amount of time and effort it takes to document the work we do, which has to satisfy more than patient care needs. Billing, medico-legal and quality measures have invaded the notes we write to support patient care.
Far too many physicians spend part of their nights and weekends finishing their patient notes. It's a complex problem that involves many stakeholders including government, insurance payers and quality organizations.
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