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September 7, 2016

Electronic health records might make doctors ill

There are many benefits in using electronic health records, such as combining otherwise fragmented health data and easier access to this data. Getting to grips with new EHR systems is costing physicians a lot of time, a new US study finds, even leading to more burn outs among doctors.

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Physicians may be spending twice as much time grappling with new electronic health record (EHR) systems and related ‘desk work’as they are providing medical care to their patients, according to a ‘time and motion’ study , published in the Sept. 6 issue of Annals of Internal Medicine. 

Forbes writes that an analysis of 57 doctors in four U.S. states shows EHR systems designed to speed patient referrals and improve treatment are contributing to doctor burnout and taking away time for patient care.  For their analysis, researchers examined the work flow and patient care of doctors in ambulatory care settings such as family and internal medicine, cardiology and orthopedics. The study was funded primarily by the American Medical Association.

EHR’s soak up face time

Basically every hour physicians spent on face time with patients, some two additional hours are spent on recording information in EHR’s and related forms of desk work, the study states. Outside office hours physicians spent one or two hours of personal time each day for additional computer and other clerical work.

This means that during the office day physicians spent 27 percent of their total time on direct clinical face time with patients and 49.2 percent on electronic health records and desk work. While in the examination room with patients, physicians spent 52.9 percent of the time on direct clinical face time and 37 percent on EHR’s and desk work. The research, though limited in scope, is the latest evidence showing physicians grappling with distractions unrelated to direct patient care.

Forbes quotes Dr. Susan Hingle, a professor of internal medicine at Southern Illinois University School of Medicine wrote in a companion editorial in the Annals of Internal Medicine: “Many studies have documented lower patient satisfaction when physicians spend more time looking at the computer and performing clerical tasks. Patient satisfaction can affect health outcomes via adherence to the care plan and can also affect physician and hospital reimbursement so the stakes are high.

Moving into the digital age

In 2009, President Obama signed into law the Health Information Technology for Economic and Clinical Health Act, as part of the federal stimulus legislation known as the American Reinvestment and Recovery Act. The legislation provided more than $20 billion to help doctors and hospitals move into the digital age through the use of electronic health records and related health information technology.
Now as most physicians have had several years of experience with electronic health records, doctors say the change is negatively impacting patients and potentially health outcomes. That was not intended when the above mentioned legislation was created to coax doctors into using electronic health records.

Downside has an upside

However, the problems doctors face with EHR’s has an upside for healthcare IT vendors like Cerner, Epic, General Electric, Allscripts Healthcare Solutions, Siemens and McKesson, Forbes writes. Insurers like Aetna, which owns Healthagen, and UnitedHealth Group’s Optum subsidiary also profit from working with physician practices on population health and related patient management services as healthcare payments move away from fee-for-service medicine to value-based care.

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