U.S. physicians broadly began to adopt Electronic Health Records (EHRs) as mandated by the American Recovery and Reinvestment Act (ARRA), which includes Meaningful Use requirements and penalties on proper EHR implementation to enhance the quality and standards of medical patient care. An official 2014 research study conducted by RAND Corporation (a non-profit that researches, analyzes, and advises on strategic decisions and policies) revealed that physicians are clearly dissatisfied with their EHRs for numerous reasons.
RAND’s research study sample surveyed healthcare professionals in 30 specialty-specific practices in 55 different practice sites (as some practices had more than one location). The endeavor consisted of written surveys and verbal interviews with open-ended questions. According to their findings, doctors generally recognized the importance advances facilitated by EHRs but still struggled with EHR integration in their practice. Below is a more detailed examination of their EHR challenges.
EHR’s cumbersome configurations prevent physicians for rendering efficient medical care to patients
Personal interaction between physicians and patients becomes hindered due to inefficient and complex EHR design. Physicians take more time to document medical records on EHRs than paper charts in some cases, and a portion of this documentation holds little or no value for recordkeeping or claims purposes. A ton of pop-up reminders, electronic messages, complicated menus, and interfaces that aren’t user-friendly cause more time-intensive data entry and frustration for doctors.
Moreover, EHRs often require physicians to complete certain data entry and other administrative actions in the software that their personnel should be able to do. Physicians noted that their transcriptionists and other administrative personnel were able to manage medical records faster outside of EHR data entry. In any case, EHR systems need to be configured in such as a way as to leverage each individual’s productivity within the medical practice according to state licensure regulations.
EHRs often don’t account for specific medical specialties that are part and parcel to practices
Each medical practice incorporates its own work patterns and flows based on its specialty (i.e. dermatology, ophthalmology, gynecology, cardiology, and so on). Further, medical practices vary in size and settings. Most EHRs are created with a one-size-fits-all approach that doesn’t offer flexibility for all of these variables (e.g. specialty, size, and location). The American Medical Association (AMA) recommends EHR software to be designed in a more modular fashion so physicians can tailor their Health IT systems to fit their medical specialties and organizational systems. Along with that, EHR software vendors could create EHR applications that are specific to each medical specialty.
EHRs can’t facilitate the electronic exchange of medical records
Physicians were highly disappointed that they couldn’t send or receive medical records and clinical documentation via their EHRs. Thus, they continued to depend on more traditional mediums to exchange medical information, such as faxes from outside healthcare providers. Medical data input into these applications is essentially “locked in,” where the import and export of data is not possible. An EHR with this functionality would generate a multi-sourced and more complete medical record that could be accessed by any physician at any time for improved patient care.
AMA President-elect Steven J. Stack M.D. said this about physicians’ experiences with EHRs:
“Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work. This has resulted in physicians feeling demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.”
AMA and RAND Corporation found that the majority of healthcare professionals don’t want to return to paper records but feel that current EHR software slows down patient care rather than streamlining it. Several other research studies agree with this sentiment; for example, an International Data Corporation study found that 58% of ambulatory physicians were unhappy with their EHRs.
Dr. Stack also states:
“Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus.”
One could suppose that EHR technology is still in its innovative stage that includes a period of transition and troubleshooting for full-service and full-function EHRs. However, no other industry is universally required under law to implement a particular technology that wasn’t completely ironed out and satisfactory to its target end users. With this in mind, the AMA is spearheading a more proactive campaign to improve the functionality and usability of EHRs, such as collaborating and advising federal legislators on EHR certification and Meaningful Use requirements, working with EHR software developers to improve the EHR user experience, and assisting physicians in their purchase and adoption of EHRs. Hopefully, this will reduce the amount of challenges that physicians face with EHRs.