Electronic Health Records Cause Professional Dissatisfaction

The cumbersome nature of electronic health records (EHRs) interferes with patient care and causes frustration among physicians, according to a new study.

Researchers at RAND Health (Boston, MA, USA) collected data from 30 physician practices in six US states (Colorado, Massachusetts, North Carolina, Texas, Washington, and Wisconsin) between January and August 2013. The number of physicians in each practice ranged from fewer than nine to more than 50 and the practices included single and multispecialty, as well as primary care. Nineteen practices were physician-owned or partnerships; 11 were hospital-owned or some other type of ownership. In addition to surveying physicians, the researchers conducted in-depth interviews with 220 physicians, medical administrators, and allied health professionals to better understand the issues that drive doctors' satisfaction with their work lives.

The survey results showed that overall, physicians approved of EHRs in concept, noting they allow remote access of patient information, improve some aspects of quality, and allow for better communication within a practice; in fact, only 20% of physicians expressed a desire to return to paper. However, their daily interaction with EHR systems appears to have taken its toll, as physicians blame the technology for lowering the quality of care they can deliver to patients.

The physicians also claimed that current EHR systems do not seem to offer a sufficient level of intuitive, user-friendly operation that would make workflow easier and less time-consuming, thereby allowing more time with patients. Some of the complaints by the physicians include time-consuming data entry, user interfaces that do not match clinical workflow, interference with face-to-face patient care, information overload, lack of health information exchange between EHRs, and expenses incurred that threaten practice finances.

“The results of the study indicate that the problem is one that will not abate as physicians become more familiar with EHRs. The issue is about the fundamental state of interoperability with the technology and not one of familiarity,” concluded lead author Mark Friedberg, MD. “Electronic health records were a source of both promise and frustration, with major concerns about interoperability between systems and with the amount of physician time involved in data entry.”

The 2009 American Reinvestment & Recovery Act (ARRA) includes many measures to modernize infrastructure, one of which is the Health Information Technology for Economic and Clinical Health (HITECH) Act, which supports the concept of meaningful use, defined as ensuring that certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care.

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