According to a study published in the American Journal of Emergency Medicine, physicians in one emergency room spent 44% of their time entering data in their electronic medical records (EMRs). In contrast, only 28% of their time was spent on direct patient care. Little wonder then, that most physicians are frustrated with EMRs, and are rapidly starting to resent them!
In this digital era, with the world being increasingly connected, EMRs are not just inevitable but also a necessity. For one thing, they keep information readily available and accessible, which has got to be a good thing for the healthcare industry as well as for physicians and patients. But then, why are these EMRs are being ridiculed and scorned almost universally?
There are a host of reasons that physicians or EMR users cite. Let’s take a look at the most prominent of them.
Foremost, is the amount of time that it takes them to fill data into the system. Most physicians find that entering data is a cumbersome and time-consuming process, which reduces patient face-time. Doctors admit that they lack the necessary keyboard skills, and mention that as the reason for data entry interfering with their patient time. Be that as it may, it still means that they find EMRs more of a hindrance than a help. This ultimately results in lower quality healthcare. So, what’s the alternative? The only option seems to be that physicians spend more time at work, and later spend that extra time filling up the forms. That, however, would add more working hours to an already taxing day. Eventually, this will also have an impact on the healthcare provided.
Some physicians did use macros or templates to help in the cumbersome process of data entry. But, even this was not very helpful. After all, template-based notes are seen as having the potential for misuse. They are also considered a threat to both the quality of clinical care and professional satisfaction.
Another reason why physicians find EMRs frustrating is the user interface. Very often, the interfaces for the EMRs are counterintuitive at best and problematic at worst. The common grouse is that most EMRs do not follow the clinical workflow that physicians are used to. In some extreme cases, doctors have even had to redesign their workflow to accommodate the EMRs.
Add to that the fact that there are multiple EMRs for multiple specialties and practices, while almost none of them exchange information amongst themselves. This failure of EMRs to share and exchange information only means that time is unnecessarily spent on entering what amounts to duplicate data.
Further, EMRs invariably resulted in an information overload for the physicians. Most EMRs feature email alerts for doctors, and this has resulted in a voluminous increase in the quantum of messages reaching them, substantially more than anyone can hope to handle diligently.
Love them or hate them, EMRs are here to stay. It is nevertheless imperative that practitioners adopt EMRs rather than have them thrust on them. That can still happen by a shift in thought, rather than an extensive ground up rework of the whole system.
One could start with something as simple as not having physicians unnecessarily fill out the same data twice. Making all systems compatible will mean that patient data entered into one system can be easily imported into another. This will go a long way towards reducing the data entry burden.
This interconnected application will also mean that doctors need not spend time repeating the same documentation work, each time they have to do the same procedure.
Allowing voice recognition software to interface with the system will help doctors who have poor keyboard skills. They can just dictate their notes.
EMRs could see more widespread acceptance if the concept of healthcare becomes more ‘connected’.
Learn more about George Vijay, our Healthcare Informatics Evangelist.
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