If you have visited your physician in the last five years, you probably noticed how they do their best to give you their full attention — while simultaneously trying to document your conversation on the keyboard of a computer or tablet.
It is illegal to text and drive at the same time, but the requirements of the electronic medical record (EMR) make these simultaneous activities mandatory in your doctors office.
You already know how it often comes between you and a satisfying interaction with your doctor, NP or PA. Well, physicians hate it even more than you do. Now we have nine specific reasons why.
The results of the Physician Satisfaction Study, sponsored by the RAND corporation and the AMA, became available last week and all 122 pages are a treasure trove of information on how to lower stress, prevent physician burnout and create more satisfaction in your organization.
(Here is a link to a PDF of the full study report.)
One of the biggest items found to interfere with physician satisfaction is the current state of electronic medical records documentation
=> Physicians found three things to like about their EMR
=> And nine ways EMR interferes with quality patient care and physician satisfaction
=> A full 18 percent of the participants still want to go back to paper charts
The researchers went on to make this statement which, while true, is of little consolation if you find yourself working into the evening hours to get your EMR based documentation completed.
Worsened Professional Satisfaction:
I am going to simply provide paragraphs directly from the report below. If you are a physician, I am certain you will see your personal frustrations well represented.
1) Time-Consuming Data Entry
“The majority of physicians who interacted with EHRs directly (i.e., without using a scribe or other assistant) described cumbersome, time-consuming data entry.”
2) User Interfaces That Do Not Match Clinical Workflow
“Beyond data entry, physicians and their colleagues described EHR user interfaces that, in important ways, hampered rather than facilitated their clinical workflow. Non-intuitive order entry was particularly problematic.”
3) Interference with Face-to-Face Care
“Multiple physicians who entered their notes via keyboard described their EHRs as interfering with face-to-face patient care. Many of these physicians blamed themselves for lacking the ability to type without compromising the level of attention they could devote to patients. These physicians faced a difficult trade-off: divide attention between the patient and the computer, or defer data entry until after leaving the patient, lengthening overall work hours.”
4) Insufficient Health Information Exchange
“Physicians in multiple specialties and a range of practice settings described frustration when health information was not exchanged between EHRs. Even when practices invested in EHRs, faxes were a common mode of communicating patient information between care settings.”
5) Information Overload
“Some EHR products feature automatic email alerts to physicians. For primary care physicians in particular, this has created a sense of information overload — the unceasing volume of messages reaching them has expanded beyond the number that they believe they can handle diligently.”
6) Mismatch Between Meaningful-Use Criteria and Clinical Practice
“Both primary care and subspecialist physicians noted a mismatch between meaningful-use criteria and what they considered to be the most important elements of patient care.”
7) EHRs Threaten Practice Finances
“Some physicians, especially those who owned or who were partners in their practices, reported that investing in EHRs exposed their practices to significant financial risks. In particular, the costs of switching EHRs — which could become necessary due to factors beyond a practice’s control — were of high concern.”
8) EHRs Require Physicians to Perform Lower-Skilled Work
“Physicians who did not use scribes reported that their EHRs required them to perform tasks below their level of training, decreasing their efficiency.”
9) Template-Based Notes Degrade the Quality of Clinical Documentation
“While some physicians described using templates (or “macros”) to ease the writing of clinical notes (i.e., to overcome data entry problems), many described misuse of template-based notes as a significant threat to both clinical quality and professional satisfaction. Such notes were described as complicating the task of retrieving useful clinical information. This problem was reported by physicians in all specialties and practice models included in the study.”
