Are EHR Systems Really That Stressful?
May I simply say “Nay” to the “Nay-sayers” on the topic of EHR systems stressing clinicians into the burnout tail spin.
My nine Family Practice group is self-owned and self-managed. It owes much of its clinical and financial success to the effective use of an EHR system deployed in 2002. It is true, practice stressors are very real and at times burdensome, but none of us have deemed the data system as the primary culprit. It can certainly be the momentary focus of anger due to a delay or confused work flow. However, the EHR is no more to blame than the screen providing an aggravating news report. The EHR is simply a tool!
Improvements Due to the EHR
We have found our EHR to clearly improve patient care and provider experience. This occurs via the enormous data tracking, organization, cross referencing and expedited processes in the day to day delivery of clinical care. Yes, it took the first three years of data seeding to feel the glory. Yes, my dream of more interoperability has been slowly improving since the start of HL7 lab imports in 2006. So much more to be done! More importantly, so much progress has been made! From 2005 to 2015 my group has enjoyed the “upside” of the expedited data systems. The journey has been rewarding, patient pleasing, and helps transparency and clarity. Recently we began flogging ourselves with competitive metrics and focusing on our “care gaps” that is often misinterpreted as our personal inadequacies.
My clinical care and management life is an ecosystem of overly complex and continuously variable workflows superimposed on the personal and emotional commitments to my patients, my staff, my community, and lastly myself. I fear that the “lastly myself” is key in much of physician burnout. Let me elaborate by addressing some of the current research anchor points for blaming the EHR tool.
The Importance of EHR Tool Familiarity
First, as in all tools used by mankind, the human is the most creative and flexible piece of the system. We should be the malleable and innovative part of the workflow machine. To achieve this effectively, one must be very familiar with the EHR tool. This requires training, stability, experience, and re-training. Do “EHRs add to the frustration of my day”? No more so than dictating, signing off transcription, answering numerous calls to clarify my poor handwriting and sorting through paper charts for critical information. Did I mention that three of my eight partners have never used a paper chart? Nor have they ever needed to remember phone numbers for a rotary dial?
Accepting EHR Tools Positively Impacts Efficiency
Secondly, as the business of healthcare squeezes, physicians are prone to fill in more work and longer hours rather than accept market forces or retool and reinvest to be more efficient. The most common complaint is that practitioners are spending moderate to excessive amounts of time on EHRs while they were at home. Well, who is in control of that dynamic? Our young physician workforce is the first wave of humans who have lived entirely in the “wired” world of the World Wide Web. The application of connected technologies for the betterment of humanity can be balanced by the void of connectivity for the betterment of the human. All of us have (mostly) happily retooled how we communicate with smartphones, etc. We’re not trying to rotary dial on those. Why would we want to be less efficient and replicate old processes when we can optimize how we use our EHRs and how they can actually speed up mundane and repetitive clinical work processes?
EHR Systems Are Not All the Same
Thirdly, some EHRs are more physician friendly than other EHRs! True! Also, like any intimate partner, change, divorce, and new relationships are terribly disruptive. For those of us “reporting insufficient time for documentation while at work”, I say learn your tools and discern your needs. Often stability of your EHR systems and modifying the human workflows are more rewarding and less upsetting than looking for the perfect fit in this overly complex and continuously variable experiment we call the American Healthcare System.
Dr. Eric Weidmann graduated from the University of Texas at Austin, College of Engineering and then earned his Doctor of Medicine from the University of Texas Southwestern Medical School in Dallas in 1985. He joined SAMC in 1989 and is a Diplomate of the American Board of Family Practice. Dr. Weidmann serves as the Chief Medical Officer at eMDs.