Friday, September 26, 2014

I Think These Are Pretty Important Findings Regarding The Use Of EHRs.

This appeared a little while ago.

RAND: EHR usability a 'unique and vexing' challenge to doc satisfaction

September 16, 2014 | By Marla Durben Hirsch
The RAND Corporation has released a new study warning that electronic health records worsen physicians' satisfaction, which in turn may adversely affect patient care.
The study, sponsored by the American Medical Association, evaluated data from 30 physician practices in six states, 28 of which used EHRs. Fourteen different EHR products were represented. 
The authors evaluated physician satisfaction, and determined that the "most novel and important findings" involved how EHRs affected the physicians' personal satisfaction. While most physicians like the concept of EHRs and how they enhanced remote access and electronic communication, their inadequate design and usability provided a "unique and vexing challenge to physician professional satisfaction" in areas such as increased time on data entry, interference with face to face care, interfaces that don't match workflow, poor health information exchange and a mismatch between Meaningful Use and clinical practice.
"The current state of EHR technology appears to significantly worsen professional satisfaction for many physicians--sometimes in ways that raise concerns about effects on patient care," the report's authors said. "Physicians look forward to future EHRs that will solve current problems of data entry, difficult user interfaces, and information overload.
More here:
Here is the direct link to the report:
The report is titled:

Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy

This part of the Table Of Contents is just fascinating:
“Qualitative Findings
Improved Professional Satisfaction: EHRs Facilitate Better Access to Patient Data
Improved Professional Satisfaction: EHRs Improve Some Aspects of Quality of Care
Improved Professional Satisfaction: Better Communication with Patients and Between  Providers
Worsened Professional Satisfaction: Time-Consuming Data Entry
Worsened Professional Satisfaction: User Interfaces That Do Not Match Clinical Workflow
Worsened Professional Satisfaction: Interference with Face-to-Face Care
Worsened Professional Satisfaction: Insufficient Health Information Exchange
Worsened Professional Satisfaction: Information Overload
Worsened Professional Satisfaction: Mismatch Between Meaningful-Use Criteria and
Clinical Practice
Worsened Professional Satisfaction: EHRs Threaten Practice Finances
Worsened Professional Satisfaction: EHRs Require Physicians to Perform Lower-Skilled Work
Worsened Professional Satisfaction: Template-Based Notes Degrade the Quality of Clinical
Documentation
Future Effects on Professional Satisfaction: Physicians Express Optimism About EHR
Development in the Long Term
----- End Extract.
The study was conducted a year ago with the support of the American Medical Association and they have suggested a response to this here:

AMA presses for better EHRs

Posted on Sep 17, 2014
By Bernie Monegain, Editor
The American Medical Association, which represents more than 200,000 members, says its time to fix poorly designed EHRs so doctors can use them more effectively and better serve their patients.
The demand follows an AMA study with RAND Corp. confirming that physician frustration with EHRs is taking a significant toll not only on them, but also on their patients.
Calling the need for better EHR design "urgent," the AMA on Tuesday released a new framework outlining eight priorities for improving EHR usability to benefit caregivers and patients.
"Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work," AMA President-elect Steven J. Stack, MD, said in announcing the initiative. "This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients."
Among physician concerns that the AMA highlighted is that EHRs are cumbersome, requiring too much time-consuming data entry, which leaves less time for patients.

Other studies support the findings, the AMA points out, including a recent survey by International Data Corporation that found 58 percent of ambulatory physicians were not satisfied with their EHR technology, "most office-based providers find themselves at lower productivity levels than before the implementation of their EHR" and that "workflow, usability, productivity, and vendor quality issues continue to drive dissatisfaction."
Lots more here:
Very useful and interesting stuff in my view.
David.

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