Saturday, October 19, 2013

Physicians say they dislike regulations on use of electronic health records, but they don't want to go back to paper records

Doctors say use of electronic health records is one factor contributing to physician dissatisfaction because it interferes with patient care, says a new study.

Surveyed physicians blame EHRs for reduced quality of care, saying that their daily interaction with "clunky" EHR systems contributes to their dissatisfaction, which is closely linked with their ability to provide quality care, reports Chris Kaiser of MedPage Today. The results were published in a study by the RAND Corp. and commissioned by the American Medical Association.

Physicians said the cumulative burden of rules and regulations affecting clinical practice, including “meaningful-use” rules for EHRs, also detracted from professional satisfaction, says the report brief. These rules were created by the federal Centers for Medicare & Medicaid Services; providers must certify that they are “meaningfully using” their EHRs by meeting established thresholds in order to qualify for the program's financial incentives. If providers accepting Medicare do not qualify by 2015, their Medicare payments will be reduced by 1 percent each year, says

Despite their dissatisfaction with the regulations, physicians said they approved of the concept of EHRs, saying that their use has numerous benefits, including being able to remotely access patient information and improving in-practice communication, says the report. Only 20 percent of physicians said that practices should return to paper documentation.

“Physicians believe in the benefits of electronic health records, and most do not want to go back to paper charts,” said Dr. Mark Friedberg, a natural scientist at the RAND Corporation, in a news release. “But at the same time, they report that electronic systems are deeply problematic in several ways. Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients.”

The problem is that many EHR programs aren't user-friendly. This problem should be addressed, says the report, to ease physician workflow and free up time for the physician to spend with the patient. Here are some of the complaints physicians had about EHRs:

  • Time-consuming data entry 
  • User interfaces that do not match clinical workflow 
  • Interference with face-to-face patient care 
  • Information overload 
  • Lack of health information exchange between EHRs 
  • EHRs are expensive, threatening practice finances

  • Understanding physicians' professional satisfaction is important because better patient care is a potential "downstream" benefit of satisfaction. The researchers said knowing reasons for dissatisfaction can lead to targeted interventions to address the issues,says the news release.

    "Aside from viewing better patient care as a potential consequence of better physician professional satisfaction, it may be useful to think of physician dissatisfaction, when it is caused by perceived quality problems, as an indicator of potential delivery system dysfunction," says the report.

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