Why EHR systems are Failing Doctors (and costing them thousands of dollars) by Robert J. Foley

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1 Why EHR systems are Failing Doctors (and costing them thousands of dollars) by Robert J. Foley Electronic Health Record system (EHR for short, and also referred to as EMR ) adoption is on the rise in the United States, as many healthcare providers have come to accept the growing role of technology in healthcare. But, while adoption is on the rise, so too is disappointment. Without question, EHRs are here to stay. And they will have an increasing impact on healthcare delivery for years to come. The movement has the perfect union of corporate and government interests to assure its adoption. While accepting the inevitability of Electronic Health Records in healthcare, however, one cannot dismiss the overall disappointing success ratings they have garnered to date. This report provides key facts and figures that help explain the conundrum that both corporate and federal interests find themselves in with respect to EHR acceptance (or the lack of) by treating physicians. From exaggerated capabilities to unkept promises, you will see data from the doctor s perspective. How quickly are doctors accepting EHRs? As of May 2013, nearly 50% of doctor s offices in the United States were using an Electronic Medical Record system. i Source: The Department of Health and Human Services, May, 2013 From , physician adoption of EMRs grew by at least 66%. ii Source: HealthIT.gov Note of interest: This growth followed the passing of The Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH). #1 technology concern of practicing physicians who were surveyed is the adoption and implementation of Electronic Medical Record systems. iii Source: 2013 survey conducted by PhysiciansPractice.com How well have EHRs performed - in the eyes of the doctor? 46.3% of doctors who adopted an EMR said they would not recommend their EMR vendor to another practitioner. iv Source: 2013 survey conducted by PhysiciansPractice.com

2 Overall user satisfaction dropped by 12% between 2010 and 2012, and the very dissatisfied group grew by 10%. v EHR satisfaction and usability ratings dropped from 2010 to 2012 across a broad range of practice settings, specialties and products from multiple vendors. vi Source: ihealthbeat: The clearest evidence of these perceptions of EHRs comes from an AmericanEHR survey of 4,279 physicians. Findings were presented at the Healthcare Information and Management Systems Society conference in March, 2013 by representatives of the American College of Physicians and AmericanEHR Partners." Do EHRs make doctors more productive? 34% of users (compared to 19% in 2010) were "very dissatisfied" with the ability of their EHR to decrease workload. vii 32% of users said they had not returned to pre-ehr levels of productivity, compared with 20% in viii Dissatisfaction with ease of use increased from 23% in 2010 to 37% in ix Satisfaction with ease of use dropped from 61% to 48%. x Analysis: The Clash of The Doctors and The Geeks Practicing medicine is both science and art. Medical science serves as the basis of patient diagnosis and treatment. The art of medicine though, is unique to each physician. And it involves a doctor s understanding of her patient. It is where she makes her mark. Doctors develop preferred methods for treating their patients over time. These habits are formed through their own continuous trials and honed infinitum. The absolute perfect cure is nonexistent. But the goal of it keeps a doctor reaching. When doctors discover a method that works a drug, dosing schedule, procedure or other they prefer to stay with it. They develop comfort with what they can control. And they like the control, and the ability to adjust tweak - as they find appropriate for each

3 individual patient. This is why two equally excellent doctors can have two entirely different approaches to treating a condition, and both will attain equally positive outcomes. The doctor s art is that of personalizing treatment for each patient. Technology, or more specifically, software is inflexible. Voice Recognition: why doctors don t like it: 1. Steep learning curve. 2. Tedious programming of speech recognition software. 3. Lacks intuitiveness, cannot take instruction. It is notable that, while voice recognition companies promise ease of use, they also strongly promote extended training and support. Why? Because, for the average doctor, voice recognition software takes months to learn. During this time, productivity levels drop. They spend less time seeing patients and more time in front of a computer. Herein lies the selling point to purchase additional training. The doctor is tasked with teaching the software his/her voice, dictation style and commonly used language. This gets done after hours. No matter how vast a voice recognition database may be, a voice recognition program has limited intelligence. For instance, a software engineer can develop a voice recognition program with an enormous library of cardiology terms, but it will always require training as new drugs and equipment are introduced to the market. Electronic Templates: why doctors don t like them: Similar to voice recognition, the electronic templates featured by Electronic Health Record systems are also inflexible and limited in knowledge. The choices from which a doctor must choose through dropdowns on an EHR cold never be complete. The patient s diagnosis and prognosis must be matched to an item on a dropdown menu bar. Subsequently, the medical report that is generated is canned. It is talking about a patient who fits a profile, not the patient named Mrs. Jones, who the doctor has been treating for 17 years.

4 What does it all mean? Doctors are searching for options that will satisfy their requirement to work with an EHR system, while getting their reports done the way they want them. Form some, this means returning to medical transcription service. The industry is rapidly evolving, as healthcare technology vendors have begun to reluctantly acknowledge the shortcomings of their own systems I terms of usability. This understanding is opening up new options for doctors, as well as improved technologies that are easier to use. If this information interests you, and if you would like to learn more, you can get our second report when we release it, entitled, New Options for Medical Reporting for EHR Users, and also stay up to date on some other key findings along the way of our research. Get Part II of the report: i. Doctors and hospitals use of Health IT more than doubles since ii. ONC Data Brief No. 7, December 2012 Physician Adoption of Electronic Health Record Technology to Meet Meaningful Use Objectives: , Jennifer King, PhD, Vaishali Patel, PhD, Michael F. Furukawa, PhD iii. ibid iv. Doctors Are Increasingly Dissatisfied With EHRs By Ken Terry, ihealthbeat Contributing Reporter Monday, April 29, Many physicians have trouble documenting patient encounters in EHR drop-down boxes, which is an example of the poor usability of user interfaces. Moreover, current EHRs do not fit clinical workflow well, and practices have had to develop numerous workarounds to get their daily tasks accomplished. v. FierceEMR: EHR dissatisfaction on the rise, March 11, 2013 By Susan D. Hall

5 vi. vii Doctors Are Increasingly Dissatisfied With EHRs By Ken Terry, ihealthbeat Contributing Reporter Monday, April 29, Many physicians have trouble documenting patient encounters in EHR drop-down boxes, which is an example of the poor usability of user interfaces. Moreover, current EHRs do not fit clinical workflow well, and practices have had to develop numerous workarounds to get their daily tasks accomplished. viii ibid ix ibid x ibid

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