Those are the key findings in a new study from RAND Corporation, which conducted in-depth surveys with 220 clinicians and administrators in 30 practices across six states. The American Medical Association sponsored the study.
“In the practices we studied, physicians approved of EHRs in concept, describing better ability to remotely access patient information and improvements in quality of care,” report authors note. “Physicians, practice leaders and other staff also noted the potential of EHRs to further improve both patient care and professional satisfaction in the future, as EHR technology–especially user interfaces and health information exchange–improves.
“However, for many physicians, the current state of EHR technology significantly worsened professional satisfaction in multiple ways. Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction.”
The dissatisfaction was more pronounced among older physicians and those lacking support help to enter data and manage information flow. Many practices also have found the EHRs to be more expensive than anticipated.
Other factors influencing professional satisfaction include autonomy and control over pace and content of clinical work, whether their values align with those of practice leadership, whether the work content matched their training, income levels and practice finances, regulatory and liability concerns, uncertainty over health reform, and relationships with colleagues, providers outside the practice, patients and insurers.
In the conclusion, study authors returned to the role of EHRs as many of the other satisfaction influencers also are present in other lines of work.
“EHR usability, however, represents a unique and vexing challenge to physician professional satisfaction. Few other service industries are exposed to universal and substantial incentives to adopt such a specific, highly regulated form of technology, one that our findings suggest has not yet matured.”
Nearly all physicians interviewed saw the benefits of EHRs and believe in the promise of the technology, and only 20 percent wanted to return to paper records. “On the other hand, physicians cannot buy, install and use a promise to help them deliver patient care. The current state of EHR technology appears to significantly worsen professional satisfaction for many physicians–sometimes in ways that raise concerns about effects on patient care.”
The report, “Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems and Health Policy,” is available here.
