Hindrance or help? EHRs can be a bit of both

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 - Frustrated Doc

Electronic health records (EHRs) are implemented in hospitals to make working with patient data easier and safer. But not all hospitals see the advantages of entering the technological age. A recent story in the Boston Globe detialed how one system at Partners HealthCare at Brigham and Women’s Hospital went from a well-oiled machine to a slow demanding technological drain on efficiency.

With a 75.2 percent adoption rate by the end of 2014, EHRs are becoming the new norm in most hospitals. Yet the obstacles that come with using new technologies are still being tackled by hospital staff on a daily basis. Some troubling obstacles include acquisition and operational cost concerns, lack of physician cooperation and overall complexity.

Some physicians even argue that instead of bringing patients and doctors together, EHRs are driving them further away.

“In our culture, I believe that the public largely expects doctors to pay attention to patients and to care for and about their patients,” said Cheryl L. Branche, MD, MLS. “The patient expects privacy, her dignity upheld; she does not expect the doctor to be multitasking, that is, performing data entry and focusing on the EHR.”

With time now spent in front of a computer screen instead of with a patient, doctors are forced to work longer hours doing data entry rather than treating patients. Even the simple tasks of order prescriptions have taken longer for doctors to perform while the patient is forced to wait while doctors navigate the many pages and popups that are necessary to fill out.

“It is incredibly disruptive for physicians and nurses to make use of a new electronic health record,” said Steven J. Stack, MD, president of the American Medical Association. “The current generation of electronic health records are not very usable. They are not well designed to increase our efficiency and to make our work easier—but rather, they slow us down.”

Partners has spent $1.2 billion on the software made by Epic Systems Corp. in Verona, Wis. Although often criticized for its high price tag, Epic’s software is used by most of the top medical systems across the U.S.

Luckily, not all physicians are having trouble with the new system. After 18 hours of training before switching to Epic’s software, Marie Pasinski, MD, a neurologist at Massachusetts General, said it helps her more quickly review referrals, prescribe medications and enter notes.

“It’s made me much more efficient,” she said. “I find I’m actually leaving the office a little earlier.”

Many hospitals cite decreases in efficiency after implementing an EHR system, according to the research firm IDC Health Insights, but after a few weeks most doctors are able to cope with the forced movement into the new age of healthcare technology. Thomas J. Lynch Jr., MD, chief executive of the physicians group at Massachusetts General, said most doctors are adapting. But he acknowledged the system has a way to go before it becomes simple to use.

“It’s a huge change. It’s not an intuitive program, it’s incredibly complex,” Lynch said. “Not everything is Uber or OpenTable.”