All conversations about physician burnout eventually come around to the topic of EHR systems. The ongoing struggle with EHR systems is a chronic complaint, and physicians can feel that they are held hostage to their software. "If you're using a particular system, you have to go along with the flow," says Ron Sterling, president of Sterling Solutions, a healthcare information technology consulting firm in Silver Spring, Md., "even if that's not that way you would have done it yourself." However, there are ways to make the arrangement a little more comfortable. And there is reason to hope that things may soon improve.
"My system had the option of voice recognition software, and that saves a ton of time," says Peter Basch, MD, a general internal medicine physician in Washington, DC, and medical director of EHR and IT policy at Medstar Health. Even if voice recognition costs a little more at the outset, it generally saves money in the long run because it increases efficiency. If you've tried voice recognition before and weren't pleased, it may be worth a second look. "These programs have become much better, in the past few years" says Janis Orlowski, chief Health Care Officer for the Association of American Medical Colleges (AAMC).
You can also improve your relationship with your software by getting personal. "Medical language is a constricted vocabulary," says Basch. "Depending on your specialty or your practice, you tend to say the same things over and over." Basch recommends taking the time to personalize your software with macros and templates. "It takes a little time up front, but saves a huge amount of time in the long run," he says.
Power in Numbers
Of course, some of the problems must be addressed by vendors. "Many EHRs are put together without thinking of the user," says Basch. He describes such systems as being like a scalpel, but with the physician holding the blade end— "painful and not very efficient," he says. "EHRs are cluttered with redundant information," Orlowski points out. "Why are we including past surgeries, allergies, and so on every time? EHR's need to be smarter about displaying data," she says. You can no doubt add your own list of inefficiencies. But how to get software companies to listen?
"Vendors do listen to customer complaints," says Sterling. "But they wait for a general consensus before making changes." The best way to get the ear of your vendor is approach them as a group. If many doctors—particularly ones from the same specialty—have similar complaints, they're more likely to get results an individual grumbler here and there. Sterling also says that your chances of success are greater the more specific you can be. Rather than saying "I don't like the way this system handles orders," say something like, "I don't like that I have to cancel an order for a patient who is refusing care. I'd like to be able to leave the order as a recommended medication."
If your EHR is contributing to your burnout, it might be worth the time effort to try to improve your relationship with the software.