TOP 7 PHYSICIAN
TOP 7 PHYSICIAN EHR COMPLAINTS
A recent RAND report sponsored by the American Medical Association (AMA) highlights many criticisms providers have about EHRs.
Most physicians found EHR data entry to be burdensome and time-consuming. A common complaint in many practices was that too often physicians have to perform orders and data entry themselves, which wastes clinic time. This is further complicated by excessive clicking. In these cases, EHRs actually end up becoming time drains, defeating their intended purpose as efficiency tools.
The exceptions to this were physicians who use EHRs that come with embedded templates. These are the EHRs that improve workflow efficiency and stand out above others.
Unintuitive EHR user interfaces that are built without the user in mind can actually impede clinical workflow in significant ways. This is one of the main factors that cause physicians to have negative perceptions of many EHRs.
For example, one physician recalled that even something as routine as discharging a patient became a hassle when one button was not clicked by mistake. In that situation, the physician and the nurse had to backtrack, both on the computer and looking in the patient’s chart, to figure out the missed step that delayed the whole process.
By comparison, a good EHR will have a customizable user interface, along with forms and terminology that can easily adapt to any clinic’s workflow and unique needs.
The increased amount of computer data entry many EHRs require is taking away from the face-to face time that physicians share with patients. In order to provide a positive patient experience, most physicians prefer to finish their data entry after patients have left, which results in longer work hours and decreased efficiency.
Faxes, a relic from a less digital era, are still a common method of exchanging patient information between clinic sites. This mode of communication is wasteful and inefficient, but many expensive EHRs have not provided an alternative to it, and still incorporate faxing in their systems (having to scan faxes into the EHR, for example).
Another complaint is that many EHRs are built without sufficient knowledge of the end user’s specific needs, with no attention to User Oriented Design. As a consequence, they may not interact well with other systems and software already in place. When the systems don’t talk to each other clinical staff has to revert to sending and scanning faxes, which defeats the initial purpose of an expensive EHR.
Meeting Meaningful Use criteria is very important for practices today, but navigating through the different requirements is a challenge. Physicians often complain that all the extra documentation that is now required to achieve Meaningful Use compliance distracts from patient care.
Many EHRs don’t offer enough features to help providers become compliant, or they don’t do much to take away from the confusion of Meaningful Use documentation.
A good EHR, on the other hand, will have Meaningful Use built into the software, in a way that is adaptable to a clinic’s specific workflow and needs.
EHRs can be a financial burden on many clinics, especially when they have to switch from an old EHR to a new one. Once installed, an EHR can also come with maintenance and training costs that further add to physicians’ grievances.
By contrast, a nimble, cloud-based EHR will be easy to install and maintain, and will have minimal hardware needs.
Templates (macros) can improve the efficiency of writing clinical notes, but they can also reduce clinical quality and make it more complicated to retrieve clinical information. There is also the danger of “robotic data”.
Adaptive templates offered by some EHRs address this problem and offer efficient templates that adapt to the clinical situations at hand.