Monday, June 09, 2014

The electronic medical record: from unbridled enthusiasm to sober assessment

The debate over the EMR, and the hype, are winding down. We've resigned to the fact that the EMR is here, and here to stay. It also appears that we've become more open about the unintended consequences. This is illustrated by a recent article in Wall Street Journal Market Watch.

One finding that surprised me a bit was that physician satisfaction with the EMR is declining. Policy makers and the general public like the idea of the EMR in the abstract. So apparently do many doctors, but later on they find that the EMR fails to live up to its promise in the real clinical world. From the article:

While most doctors like the idea of electronic health records, many are much less enamored with the reality. A survey released last year by the American College of Physicians and AmericanEHR Partners, a membership group for medical providers implementing electronic records, found that 34% of doctors using electronic records were “very dissatisfied” with the ability of their systems to decrease workload, up from 19% in 2010. What’s more, 32% of doctors said they couldn't return to their normal level of productivity after rolling out the systems, up from 20% in 2010. And the share of doctors who said they would not recommend electronic records to a colleague increased to 39% from 24% over that same time period.
A separate 2013 study of 30 physician practices by the Rand Corp. found that many doctors reported a dip in overall work satisfaction after implementing the electronic systems. Doctors said the systems increased their administrative workload, took away from time with patients and didn’t always mesh well with their other computer systems.

The article goes on to elaborate further about the decrease in the amount and the quality of time spent with patients. That's because the doctor now has two other jobs besides clinician: transcriptionist (due to the note functionality of the EMR) and secretary (due to CPOE).

Via Clinical Cases and Images.

No comments: