“Physician enthusiasm” and “health IT” don’t always fit well in the same sentence. There have been plenty of mandated deadlines and functionality requirements for EHRs and other systems, but vendors and federal initiatives don’t always take their “customers”, physicians who would use said systems every day, into account.
Medical practitioners aren’t generally anti-tech, but they balk when forced to adapt to systems that don’t work reliably and unobtrusively. If health IT vendors want clinicians to adopt their products, those systems must possess several key attributes. First and foremost, they must improve workflow and efficiency, according to a recent AMA survey.
The survey found that physicians are optimistic that health IT will improve, but they also say it has to improve. It must be beneficial to clinical practice and not create unnecessary burdens on patients, physicians, or practices. EHRs must be easy to use, must avoid stealing face time from patient encounters, and must improve clinical care, respondents said. This is a tall order, but advances such as cloud-based systems are expediting data input and simplifying processes. Less screen time can mean more face time with patients.
Most practices don’t have time to sort through myriad products and filter vendor hype, which is another obstacle to physician IT adoption. Believe it or not, the government is here to help. The Health IT Playbook, which the Office of the National Coordinator (ONC) launched last week, aims to help individual providers and those in small and midsized practices get the most out of their health IT. The playbook contains chapters on a wide variety of IT-related topics, including EHR, value-based care, and patient engagement.
The trouble with health IT
The “increased computerization of the practice” was cited as a significant contributor to physician burnout in this year’s Medscape report, moving up from ninth place in the 2013 study. Seventy percent of physicians surveyed this year said EHR technology decreased their face-to-face time with patients, and 57 percent said it detracted from their ability to see patients.
Physician satisfaction with the clerical burden of EHRs, computerized physician order entry (CPOE), and communication via patient portals is low. However, the risk for burnout associated with the use of some of these technologies is high, according to the results of a 2014 national survey across various medical specialties and practice settings. Moreover, the association between technology use and burnout persists regardless of the perceived value of the tools.
So far, EHRs and CPOE systems aren’t making physicians’ lives easier, according to a national study of physicians by Mayo Clinic. Furthermore, those using EHRs and CPOE systems in their practices are not only less satisfied with their clerical burden, but also at higher risk for professional burnout, the Mayo study found.
ECRI has released research showing increasing interoperability and data sharing among IT systems might also be driving the risk of failing to associate the right patient with an action (wrong-patient errors). Incorrect patient identification can occur in any setting and during procedures or processes, including patient registration, electronic data entry and transfer, medication administration, medical and surgical interventions, and patient monitoring.
Patients aren’t waiting for physicians or anyone else to get comfortable with healthcare IT; more than ever, they want their medical information. Also, patients don’t care what EHR their physician uses. At least, it’s less of a priority than a practice’s location or whether or not the physician accepts their insurance. Research from Kaiser shows patients want to access and use their medical data, including physician notes and information stored on their EHR.
Nearly 40 percent of patients support using technology to diagnose their own ailments, according to the Kaiser study. Not surprisingly, only 18 percent of physicians felt that way. Thirty-one percent of physicians report lack of ease with using technology for patients’ self-diagnoses and prefer in-person consultations; only 13 percent of patients cited the same lack of tech savvy.
Cumbersome technology is one source of the unprecedented pressure physicians feel in today’s medical practice. An unscientific internet search on “Technology as factor in worker burnout” recently yielded 2.7 million results. Some of the non-advertisement results were: “Job burnout,” “The six causes of professional burnout and how to avoid them,” and “Effects of job-related stress.”
Physicians have plenty of technology about which to be miserable, but this search shows medical professionals are not alone in feeling high levels of job-related stress. The top results in the search concerned employees in the IT sector. If the people who build the systems that can lead to physician burnout are feeling stressed themselves, there might be a new opportunity for collaboration or at least commiseration.