Five things your physicians hate about your legacy EHR

Physicians and EHRs have had a somewhat testy relationship since the major uptick in EHR adoption over the last decade.

With the introduction of new technology purported to revolutionize healthcare, the introduction of EHRs into the practice of medicine represented a disruption to collecting and sharing clinical information, and to an how physicians made diagnoses and provided treatment.

In a profession whose approaches to interacting with patients and documenting and using clinical information have remained the same for hundreds of years, introducing a technology-based disruptor to probably was not going to bode well if one’s goal was to have physicians fully on board for EHRs. The discontent appears to be more profound when physicians are using outdated legacy EHRs which can make work life difficult for an already skeptical group.

Evidence shows that the reception EHRs received among physicians was cool bordering on frigid. Survey data indicates the EHR skeptics are not a fringe minority, rather according to recent survey physician dissatisfaction with EHRs runs fairly high.  The discontent physicians display toward legacy EHRs is a reflection of the deficiencies these system display.

Based on the surveys and studies conducted on physician attitudes the following represent five areas in which physicians have expressed dissatisfaction with legacy EHRs. These areas of dissatisfaction are a reflection of some of the problems inherent in legacy EHRs many physicians still use that do not contain many of the enhanced workflow and security features found on newer EHRs.  

1. It eats up time with patients

EHRs have earned the reputation among physicians as distracting from valuable time spent facing patients. Rather EHRs have required doctors focus on inputting data into the system and navigating between screens. Doctors report spending twice as much with their EHR as they spend talking with patients. The study found the physicians studied “spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work.”

2. It reduces physician productivity

EHRs, in theory, should enhance productivity.Whether and to what extent productivity is enhanced by this technology is a matter of debate, but seven out of ten physicians think that EHRs reduce their productivity. Reduced productivity among physicians still using legacy EHRs can partially be attributed to design flaws in some of these systems which make poorly designed workflows.

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3. It offers a poor return on investment

Physicians are also skeptical of the direct and indirect costs related to EHR use. Nearly 75% of physicians described their EHR investment as not worth the effort, resources, and costs. Similarly in the Deloitte study referenced previously 3 out of 4 physicians felt that EHRs increase practice costs, outweighing any efficiency savings.

4. It increases physician burnout risk

With reduced production and increased time spent on administrative tasks, physicians are also expressing concerns that the introduction of EHRs is contributing to burnout due to inefficient data input features and workflow structures on legacy EHRs. Out of 6,560 physicians surveyed on burnout, the majority of respondents stated their EHR use was “a cause of clerical burden, contributing to feelings of emotional exhaustion, depersonalization and a reduced sense of personal accomplishment, i.e., physician burnout.”

5. Reduced care quality, higher risk, and poor security

Despite received wisdom that EHRs improve the quality of clinical care and reduce risk physicians, likely due to feelings of burnout, and reduced production has expressed concern that EHRs increase patients. For example, an Association of American Physicians and Surgeons survey found about 80% of the 571 physicians surveyed felt EHRs impede patient care and almost half say patient safety is at risk. Another 63% of the physicians surveyed said confidentiality is compromised with due to legacy EHRs outdated security features that have failed to keep pace with the sophisticated methods hackers are using to access healthcare data.  

Physician concern regarding EHRs is not simply a product of a profession who is pushing back at technological progress. Rather, the concerns expressed here could be an indicator that the products on the EHR market have failed to provide a solution that is attuned to physician workflows and is not living up to their potential.