Are Electronic Health Records Overwhelming Physicians and Affecting Patient Care?

With the increasing use of electronic health records (EHRs) in the healthcare industry, the role of physicians has been significantly altered. While digital health records have brought certain advantages, a growing concern is whether these systems might be hindering effective patient care by overwhelming physicians with paperwork and decreasing face-to-face interaction time. This article explores the impact of EHRs on physicians' workload and patient care, providing insights from the perspective of a nurse practitioner (NP).

Transition from Traditional Methods to Digital Records

Gone are the days of handwritten records and physical medical books, now replaced by computerized systems that aim to improve patient documentation and communication. An NP, recalling the era of handwritten notes, mentions that records from 90 years ago were almost illegible, while the vital sign books and other medical books on the nursing unit were scattered and hard to find. Today, this information is stored digitally, providing a more organized and accessible system.

Benefits of Electronic Health Records

EHRs have indeed brought about numerous benefits. They enhance the ability to conduct remote chart reviews, improve accessibility, and contribute to better communication between healthcare providers. On a positive note, the removed physical constraints of paper records have led to a more efficient and organized workflow within healthcare facilities.

Challenges and Drawbacks of EHRs

Despite these benefits, EHRs also present significant challenges. The process of data entry and billing can be time-consuming, with one NP mentioning that it can add anywhere from 90 to 120 minutes to their daily workload. This time is often spent clicking boxes to fill billing codes, leading to less face-to-face interaction with patients. Patients have reported that physicians spend a significant portion of their visits entering orders and data on the computer rather than listening to them, examining them, or explaining their condition.

Impact on Medical Accuracy and Efficiency

The inefficiencies in EHRs can also lead to medical errors. Different systems from various software providers do not communicate well, leading to issues like cut-and-paste misinformation, clicking errors on the wrong drug, or incorrect doses. A recent study has even shown that the use of EHRs can increase healthcare costs due to the often unhelpful nature of the dropdown menus, which can lead to extended search times and increased workload.

The Role of Scribes in EHR Management

To alleviate some of the burden, some practices have introduced scribes who assist with data entry. However, these scribes, although they can provide some assistance, are not trained in the medical field and often produce records that lack medical meaning. Furthermore, these scribes cannot replace the critical thinking and decision-making skills of physicians, highlighting the ongoing need for physician oversight in EHR management.

Expert Opinions and Implementation

The implementation of EHRs has been driven by visions of reducing medical errors and costs, as well as improving communication and accuracy. However, these goals seem to have been compromised. A memorable quote from the article suggests that the systems designed by “millennial experts” at RAND and implemented by HHS officials without proper beta testing are flawed. The sarcasm underscores the frustration with the lack of practical testing and the disconnect between theory and implementation.

The impact of EHRs on both physicians and patients is evident, with a balance needing to be struck between efficiency and effectiveness. It is crucial to continuously evaluate and adapt EHR systems to ensure they meet the needs of healthcare providers and support high-quality patient care.

Conclusion

The transition to EHRs has been a mixed bag, offering some conveniences while challenging the traditional practice of medicine. As healthcare continues to evolve, it is essential to address the shortcomings of EHRs to improve both patient care and the overall efficiency of the healthcare system.