Physicians Pinpoint Frustrations with EHRs in Published Commentary | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Physicians Pinpoint Frustrations with EHRs in Published Commentary

August 18, 2016
by Rajiv Leventhal
| Reprints

Electronic health records (EHRs) have been known to frustrate physicians, and a recent commentary from practitioners in the Journal of the American Medical Association (JAMA) further clarifies what about the technology aggravates doctors so much.

The piece, authored by doctors affiliated with the Stanford University School of Medicine and elsewhere, titled “Evolutionary Pressures on the Electronic Health Record,” said that EHRs “have the potential to prevent medication errors and decrease duplicative tests, contributing to the safety and value of care.” But, the authors noted, "the evolution of EHRs has not kept pace with technology widely used to track, synthesize, and visualize information in many other domains of modern life.”

Specifically, they said that the tools are not integrated in a way that supports tailored treatment decisions based on an individual’s unique characteristics. “Existing EHRs also have yet to seize one of the greatest opportunities of comprehensive record systems—learning from what happened to similar patients and summarizing that experience for the treating physician and the patient,” they wrote.

The authors wrote that the amazing effects of computers and science are simply not seen with EHRs, leading to extra burden on physicians. “The dominant EHRs are designed for billing and not primarily for ease of use by those who provide care. In fact, a measure of successful EHR evolution may be that physicians spend much less time with the EHR than they do now,” they said. They continued, “Deimplementing the EHR could actively enhance care in many clinical scenarios. Simply listening to the history and carefully examining the patient who presents with a focused concern is an important means of avoiding diagnostic error.”

They continued, “For patients with multiple active health issues, EHRs can generate an overwhelming number of reminders, resulting in dangerous alert fatigue. Outside of healthcare, other sectors have found suitable solutions for this type of challenge: the airline industry limits pilots’ audible alerts to critical and life-threatening events, and financial software enables users to set investment goals without inundating their inbox at every price fluctuation. Better triage of EHR alerts and fewer workflow interruptions are needed so the physician can maintain situational awareness without being distracted.”

What’s more, they wrote that the most important shortcoming of the EHR might just be the absence of social and behavioral factors fundamental to a patient’s treatment response and health outcomes. “In this world of patient portals and electronic tablets, it should be possible to collect from individuals’ key information about their environment and unique stressors—at home or in the workplace—in the medical record. What is the story of the individual?” they wrote. They did add that the National Academy of Medicine has called for systematic integration of social determinants of health into the EHR, which the authors said could help clinical teams.

They conclude by saying that resentment against EHRs is only growing and every additional click just adds to doctors’ frustration. “Current records miss opportunities to harness available data and predictive analytics to individualize treatment. Meanwhile, sophisticated advances in technology are going untapped. Better medical record systems are needed that are dissociated from billing, intuitive and helpful, and allow physicians to be fully present with their patients,” they said.

Get the latest information on EHR and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Former Health IT Head in San Diego County Charged with Defrauding Provider out of $800K

The ex-health IT director at North County Health Services, a San Diego County-based healthcare service provider, has been charged with spearheading fraudulent operations that cost the organization $800,000.

Allscripts Touts 1 Billion API Shares in 2017

Officials from Chicago-based health IT vendor Allscripts have attested that the company has reached a new milestone— one billion application programming interface (API) data exchange transactions in 2017.

Dignity Health, CHI Merging to Form New Catholic Health System

Catholic Health Initiatives (CHI), based in Englewood, Colorado, and San Francisco-based Dignity Health officially announced they are merging and have signed a definitive agreement to combine ministries and create a new, nonprofit Catholic health system.

HHS Announces Winning Solutions in Opioid Code-a-Thon

The U.S. Department of Health and Human Services (HHS) hosted this week a first-of-its-kind two-day Code-a-Thon to use data and technology to develop new solutions to address the opioid epidemic.

In GAO Report, More Concern over VA VistA Modernization Project

A recent Government Accountability Office (GAO) report is calling into question the more than $1 billion that has been spent to modernize the Department of Veterans Affairs' (VA) health IT system.

Lawmakers Introduce Legislation Aimed at Improving Medicare ACO Program

U.S. Representatives Peter Welch (D-VT) and Rep. Diane Black (R-TN) have introduced H.R. 4580, the ACO Improvement Act of 2017 that makes changes to the Medicare accountable care organization (ACO) program.