Friday, May 26, 2017
Thoughts On Creating EHRs That Clinicians Are Actually Reasonably Happy To Use And Don’t Burn Them Out.
We had two relevant articles (and an extra) appear this week. First we had:
May 22, 2017
When the American Medical Association (AMA) last year announced study results that found physicians spend nearly half their office day entering data into electronic health records (EHRs) and handling other administrative deskwork, the organization said poorly designed EHRs were part of the problem.
“If you were to start from scratch, you wouldn’t come up with the systems we have today,” said Jesse M. Ehrenfeld, MD, MPH, an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine who was elected to the American Medical Association Board of Trustees in 2014.
The AMA developed a list of eight items it believes vendors need to improve or develop to make EHRs better for physicians and their staff.
The list starts by saying systems should
1. enhance physicians’ ability to provide high-quality patient care;
2. support team-based care; and
3. promote care coordination.
The AMA also asks vendors to
4. offer product modularity and configurability;
5. reduce cognitive workload;
6. promote data liquidity;
7. facilitate digital and mobile patient engagement; and
8. expedite user input into product design and post-implementation feedback.
“If all vendors took these to heart, things would really improve,” Ehrenfeld said. “We want tools that help us provide high quality care and make the process of care easier and more efficient. Mobile technologies, voice recognition, imaging and sensing are all things we see in the world around us, but we don’t see that happening in the EHR space yet.”
Every physician likely has his or her own thoughts about how to improve EHRs. Ehrenfeld and others offered several additional ideas, from practical improvements to solve today’s problems to visionary suggestions that could dramatically change how they practice:
Lots more here:
Second we had this covering the same material:
May 17, 2017 12:35pm
Doctors have plenty of ideas for how to improve electronic health records.
Poorly designed electronic health records (EHRs) are the bane of many doctors’ existence.
They’re blamed for an increase in physician burnout and a decrease in physician satisfaction.
“If you were to start from scratch, you wouldn’t come up with the systems we have today,” Jesse M. Ehrenfeld, M.D., an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine, told Medical Economics.
Yet those EHRs dominate doctors’ work hours. For every hour physicians spend in exam room visits with patients, they spend nearly two hours on EHRs and desk work during office hours, a study funded by the American Medical Association found.
So it’s no surprise that doctors say they can easily come up with ideas for how to improve EHRs to make them better for them and their staff.
Both articles are worth a look as they take slightly different looks at the same issue.
The link between HER use and clinician burnout is especially troubling.
A more detailed coverage of this issue is found here:
Family physicians who work in a hectic or chaotic environment, those who report high rates of job-related stress, and those who spend time at home working on electronic medical record (EMR) tasks may be particularly vulnerable to burnout, researchers report.
In a study designed to assess workplace factors associated with burnout among family physicians, Monee Rassolian, MD, from Michigan State University, Flint, and colleagues administered an abbreviated burnout survey to a random sample of family physicians applying to take the 2016 American Board of Family Medicine Certification Examination. They report their findings online May 8 in JAMA Internal Medicine.
Twenty-five percent of the final survey sample of 1752 physicians reported symptoms of burnout on the basis of the 10‑item Zero Burnout Program survey, also referred to as the Mini Z survey, developed from the Maslach Burnout Inventory. The Mini Z survey enables the assessment of burnout with a single item that correlates with the emotional exhaustion subscale of the Maslach Burnout Inventory.
Although substantially lower than physician burnout estimates in studies using the Maslach Burnout Survey, the burnout prevalence in this study is similar to that observed among academic general internal medicine physicians using the Mini Z survey, the authors note.
Of those with burnout (n = 441), 57.1% reported working in a hectic, chaotic atmosphere compared with 26.5% of those without burnout, 91.4% reported feeling a great deal of job stress compared with 38.4% of the physicians without burnout, and 62.1% spent excessive time on EMR tasks at home compared with 38.7% physicians without burnout, the authors write.
The workplace factors addressed by the survey include:
· job satisfaction;
· job-related stress;
· control over workload;
· sufficiency of time for documentation;
· the atmosphere of the work area on a 5-point scale, where 5 is hectic/chaotic;
· alignment of professional values with those of department leaders;
· ability of care team to work together efficiently;
· time spent on the EMR at home; and
· proficiency of EMR use.
Bivariate analysis identified associations between burnout and all the work-related factors except proficiency with EMR use, which was similar among physicians with and without symptoms of burnout, the authors report.
I wonder how the myHR would fit in here, given it is hardly user-friendly etc.
Posted by Dr David More MB PhD FACHI at Friday, May 26, 2017