Electronic Health Records: What Works And What Doesn’t
Which medication was my patient prescribed last week? Does she have a history of high blood pressure? Are his immunizations up-to-date?
If you are a physician, you probably find yourself asking these questions every day.
Generally, this information is readily available with electronic health records (EHRs). However, it’s not always quite so simple.
EHRs provide instant access to volumes of patient data. When printed, many EHRs are thousands of pages long—like sipping from a fire hydrant. It’s a recipe for drowning in data that may not be actionable. Analysts say that excessive amounts of data can cause physician overload, error, and fatigue.
The jury is still out on whether EHRs improve patient care overall, or create barriers and distractions. The true effectiveness of EHRs is unknown, with studies showing conflicting results.
As a physician, it’s important that you remain aware of both the benefits and drawbacks of EHRs. You can use this information to your advantage, and also look out for any potential problems they may cause.
Let’s take a look at some of those benefits and drawbacks, and how EHRs may impact patient care.
Electronic Health Records And Patient Data: Blessing Or Burden?
There are definitely noticeable benefits of EHRs. They have been shown to:
- Improve mortality rates
- Quicken the diagnosis process
- Increase patient satisfaction
- Create fewer medication errors and near-miss interactions
- Improve screenings for conditions, including certain cancers
- Make it easier to locate information and communicate with other physicians
- Decrease costs
Stories Of Success
In one initiative reported by Hospital Pediatrics (January 2017), a pediatric hospital used EHR data to decrease the average length of hospital stays for children with asthma. Another pediatric hospital leveraged its EHR to improve outcomes in half of children with chronic conditions, according to The Joint Commission Journal on Quality and Patient Safety (March 2017).
However, not everyone is as pleased with EHRs. They have noticed several downsides, including:
- Decreased productivity, especially right after implementation
- Unclear data about effectiveness of EHRs
- Patient privacy concerns
- Increased workflow interruptions
- Data entry errors
- Increased frustration due to poor usability of EHR systems
Physicians have also complained that EHRs create extra work outside of regular office/clinic hours. According to a December 2016 study in the Annals of Internal Medicine, EHRs can be serious time eaters:
During the office day:
- 49.2% of a physician’s time spent on EHRs and desk work
- 27% of a physician’s time spent on direct clinical facetime with patients
While in exam rooms with patients:
- 52.9% of a physician’s time spent on direct clinical facetime
- 37% of a physician’s time spent on EHRs and desk work
With every success story comes some not quite as successful stories.
In one incident, a patient was given an antibiotic that caused permanent kidney damage when physicians failed to notice a kidney stone on the 3,000 page EHR report.
In another, a man was told that he had a fatal cancer when another patient’s biopsy results were accidentally entered into his electronic health record.
And after a massive UCLA Health System data breach, 4.5 million patients were put at risk of having private medical information released.
Patients report that physicians who make eye contact are easier to connect with, and are more empathetic. But opportunities for eye contact dwindle when EHRs are involved.
Physicians with EHRs in the exam room spend 30% of their time looking at their screens—but physicians with paper charts only spend 9% of time looking at their charts.
The Final Takeaway
EHRs are like any other machine: They perform a function they’re designed for. When used strategically, they can be a critical part of patient care. But they also present challenges and dangers when used incorrectly or inefficiently.
Does your organization cater to physicians? Posts like these can help them improve performance and stay engaged with your organization.
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