As a member of the first group of physicians to complete the Board Certification Exam for Clinical Informatics I am proud to take the teasing from my colleagues for “drinking the Kool-Aid” as it relates to electronic health records (EHRs). Nonetheless, the impact it has had on physician burnout is undeniable. Kudos to Quint Studer and Dr. George Ford, MD for raising awareness to this issue in their recent book, “Healing Physician Burnout.”1
There are a variety of factors contributing to burnout amongst physicians. In recent years few things have created the fodder for spirited and intense hallway debates like EHRs. Computerized Physician Order Entry (CPOE), patient portals, meaningful use, ICD-10, interoperability, telemedicine, data breaches, bring your own device (BYOD), and so on. The topics of EHRs and Healthcare information technology are way too broad to address in this short article. Engaging physicians on this matter is vital in our efforts to make healthcare a better place for physicians to practice and patients to receive care.
The collective experience of Studer Group with hundreds of partners has provided insight into the four basic satisfiers for physicians: Quality, Efficiency, Input, and Appreciation. They provide a useful framework for organizations and physicians to understand and address the impact of EHRs on physician burnout.
Many physicians complain about the quality of electronic notes. Others have shared concerns about the potential negative effects of current EHRs on patient care. It is easy to get caught up in the technical details, but please remain aware of the stress on physicians that may be related to their struggles to keep up with the technology while maintaining high standards for care and documentation.
A 2013 AMA-sponsored Rand Corporation report stated physicians in multiple specialties “described having insufficient time to deliver what they perceived as high-quality care.”2 Voice recognition, scribes3 , and Advanced Practice Professionals are amongst the strategies some have used in an effort to address the time physicians spend with direct patient care.
There are grassroots efforts by organizations4 and individuals in an effort to have a voice on how technology is integrated into the delivery of patient care moving forward. The love-hate relationship with EHRs was recently portrayed in a music video parody entitled “EHR State of Mind” by ZDoggMD, a hospitalist-turned-entertainer.5 It is a clever way to put to lyrics the frustrations so many clinicians have with EHRs.
At the local level we can all do a better job of showing our appreciation for the change associated with adopting and optimizing EHRs. Recognize the physicians that have adapted well and do not overpromise when faced with IT related concerns for which there are no easy answers.
Please consider the practical hurdles created by EHRs when evaluating where there are opportunities to minimize the negative impact and maximize the benefits for physicians. Engaging physicians has become increasingly important as organizations and physicians join forces to deliver excellent healthcare to the patients we are blessed to serve every day.
References:
- Studer, Q., “Healing Physician Burnout”, Firestarter Publishing, 2015.
- Friedberg, M. et al., “Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy,” Rand Corporation, 2013.
- Caiola, S., “Medical scribes help relieve doctors’ digital record keeping,” Health & Medicine, January 2016.
- http://breaktheredtape.org/
- http://zdoggmd.com/ehr-state-of-mind/ ; https://www.youtube.com/watch?v=xB_tSFJsjsw#action=share
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