Problems With Electronic Medical Records

Issues with Electronic Medical Records and Physician Burnout

Studies have identified that the problems with electronic medical records have a connection to physician burnout. The increasing clerical burden demanded of physicians is one of the biggest drivers of burnout in medicine. Also, the studies show that physicians spend 2 hours a day with work that is not reimbursable for every hour they spend with patients. Many physicians are performing this work after hours on nights and weekends. However, working after hours has enabled organizations to continuously increase productivity targets without changing the infrastructure or support system, basically adding a week of work for the physicians every month.

With all of the additional burdens placed on the physicians, it’s easy to see why burnout rates are now twice as high in medicine as in other fields. The problems with electronic medical records come from system-related errors due to the flaws in the design of the EHR. For example, many EHR templates lack sufficient space for the documentation, precluding healthcare professionals from taking detailed notes during patient visits. Confusing displays and auto-population, or automatically generated data by the software, misinform medical professionals and leads to the transmission of inaccurate information. Furthermore, medical professionals are also dealing with faulty technology that may prevent them from accessing crucial information such as radiology studies or lab results.

Another one of the problems with electronic medical records is the potential for medical malpractice lawsuits. One recent case involved a physician that did not have enough room to document all of the patient’s symptoms, and that resulted in a cardiac event because of the mismanagement of the patient’s condition. Another case resulted in the delayed diagnosis of lung cancer because a physician could not access diagnostic imaging within the EHR.

The Doctor’s Company, a medical malpractice insurer, attributes the lack of input from physicians and other healthcare professionals in the initial development of EHR as the major flaw with the system itself. Thus EHR problems encountered by medical professionals have been ignored. More alarming is the reluctance of EHR vendors to address many of the software design flaws. Many of the problems with EHR’s would disappear with national standards and beta testing.

Another unintended consequence of the electronic health record is the resurgence of copying and pasting. Years ago, merely mentioning copying and pasting text in the medical history would have resulted in the termination of a transcription service. Now, copying and pasting is a common practice among healthcare professionals, which “jeopardizes the integrity” of the medical record. Copying and pasting can make it difficult for physicians and nurses to sort through and make sense of the record, resulting in the ”death’ of the health record narrative.” Medical records cluttered with irrelevant, outdated, and potentially inaccurate information reduce the ability of physicians to make effective clinical decisions for the patient.

If you want to reduce the burden placed on physicians and improve the safety of your patients, then contact us for a customized solution.

References:

Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med 2016;165:753-760.
Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015;90:1600-1613.
Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med 2017;177:195-205.
Physician burnout is a public health crisis: a message to our fellow healthcare CEOs. Health Affairs Blog. March 28, 2017.
Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc 2015;90:432-440.