Electronic Health Records (EHRs) have become increasingly popular in healthcare settings. While there are benefits to using EHRs, there are also some significant drawbacks. Let’s dive into how EHRs have changed the way physicians practice.
How They Are Beneficial
Improved Patient Care
EHRs allow physicians to access patient records in real-time and from anywhere. This means patient care decisions such as professional conferences, seminars, and workshops can be made during time away from the office. It also allows them to quickly see a patient’s medical history, including previous diagnoses, medications, and prior treatments without the hassle of deciphering physicians’ notoriously unique handwriting. This information can help physicians provide more comprehensive care for their patients.
Increased Efficiency
EHRs can be set up to streamline the documentation process, which can save time. Patient information can be entered into the system from any location, including test results and vital signs, and be instantly accessible. For example, a patient could get ordered lab work done in the morning and have the results available for the physician at the patient’s appointment later in the day.
Better Communication
EHRs can improve communication between healthcare providers from different systems. Care Everywhere is a very beneficial feature of the EPIC EMR, as it allows the ability to review a patient’s previous medical treatment that may have been completed thousands of miles away. This can help ensure patients receive the best possible care as they forget to bring their paper records.
The Drawbacks
Learning Curve
There is a HUGE learning curve when first using a new EHR system that can take a tremendous amount of time to become proficient in. The initial training may take several hours or days, and physicians may need ongoing support to learn how to use the system. This can be a significant burden for physicians already inundated with seeing patients, answering the never-ending inbox messages, and is scheduled for 20-minute appointments.
Technical Issues
Like any technology, EHRs can experience technical issues. If the system goes down, physicians may be unable to access patient information, impacting patient care. Technical issues can also frustrate physicians trying to use the system efficiently.
Pajama Time
Just as the EHR can be accessed from anywhere during times away from the office for professional obligations, it is also a few clicks away when at home. The rise of administrative tasks and the failure of health systems and employers to provide dedicated administrative time has skewed the ability to maintain a healthy work-life alignment. Brian G. Arndt et al. (2017) studied a small subset of family medicine physicians in Wisconsin and found that on average they spent 86 minutes in the EHR after hours. It is not hard to extrapolate that to the national level as a study by Arndt et al. (2016) in the Annals of Internal Medicine found that for every one hour of clinical face time with a patient, a physician spends 2 hours in the EHR.
Conclusion
EHRs can be a valuable tool and help improve overall patient care. However, they can also tremendously contribute to the physician burnout crisis and erode the critical boundary between work and personal life in a profession where an “easy” work week is 60+ hours.
References:
Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Ann Fam Med. 2017;15(5):419-426. doi:10.1370/afm.2121
Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations Brian G. Arndt, John W. Beasley, Michelle D. Watkinson, Jonathan L. Temte, Wen-Jan Tuan, Christine A. Sinsky, Valerie J. Gilchrist. The Annals of Family Medicine Sep 2017, 15 (5) 419-426; DOI: 10.1370/afm.2121