Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting a blog regarding a physicians' honest feelings towards her EHR. The article has been edited for space and is followed by comments made by readers at PhysiciansPractice.com.
Doctors are the problem with wide-spread implementation of EHRs. This is something we have been told for years. We are blamed for being averse to new technology and likened to the dinosaurs of the healthcare industry. But how many of these so-called health IT experts pause to truly think why doctors hate EHRs and how these issues can be resolved? I have been using EHRs for more than a decade, long before it was the thing to do. This was back when there were only a handful of vendors peddling their products. I am a very tech-minded person and the use of EHR spoke to me as something easy to incorporate into my practice.
Shelley says: "The same as my experience. Last year my old EHR vendor closed with very little warning to the customers. [The vendor] couldn't stay open in the face of government rules, and were too small - about 100 accounts nationwide. [This was] a great loss as it was a beautiful, worthwhile, and unique product. [My practice] went to one of the "big boys" with 80,000 doctors on board. Now, revenue is down, work time is up, frustration is up, number of patients being seen in down, wait times [are] up, shall I go on?"
Mustafa replies: "I think what would help is getting a transcription company to transcribe your notes into the EHR. We do it for many doctors with a 24-hour turnaround time. You will still be using your EHR for patient record keeping (less paperwork) and readily retrievable information (real purpose of EHRs). The cost savings are supposed to be in those terms, not by making doctors do extra work that they are not paid for."
David says: "I told you all eight years ago when I left the USS Ronald Reagan, EHR does nothing but slow productivity and give bean counters something to count. I don't have one and spend my extra 10 hours a week racing cars."
Robert says: "Amen!! EHRs are cumbersome and inefficient and have not improved the quality of patient care. In fact I feel they are a detriment to good care. We spend so much time complying with requirements forced upon us by people with little or no experience caring for patients that the patient is lost in the process. I think the overall care of patients has deteriorated since the implementation of EHRs. It has adversely affected all members of the healthcare team. Remember when nurses actually had time to care for their patients rather than entering data that no one ever reads?"
Robert replies: "Well, all those MPHs the graduate school are turning out need SOMETHING to do!"
Glenn replies: "MD, MPH.... and I absolutely DESPISE EHR. So you got the wrong group of grads. We never would have been taught to do something so anti-productive and lose half our staff."
Olajide says: "To avoid EHR distraction, I go into every new patient exam with a blank piece of paper and make notes as I go, it's more efficient and when I'm done I transfer it all to the EHR. The sad part is that it takes me three times as long to put the info in the EHR. Worse, I can't get most of the quality information in without free texting, the check boxes just don't suffice. Sad state of affairs really."
Lynn says: "I was an advocate for EHRs in the late 90's, and there were many useful choices, including roll-your-own options with macros in Word. These were Simple Object Access Protocol (SOAP) notes that we all understood, BUT the hospital/clinic wasn't able to bill for every q-tip. We got the back office directed, they're smart enough to learn the EHR that caused me to leave the paid practice of medicine. Now, I'm volunteering where paper records are used because billing isn't important. It's medicine that's fun again."