Are doctors the main barrier to electronic patient records?

Earlier this year I wrote about a study highlighting the slow pace of the rollout of digital patient records in the UK health system.  The analysis, which is believed to be the first of its kind, examines the progress made in transferring patient records to digital, and shows a complex picture best by poor understanding of IT implementation and an underestimation on the kind of changes digitization would bring.

A new study suggests that a major part of the problem might be physicians themselves.  It reveals that many doctors regard maintaining electronic health records (EHRs) a chore that undermines their relationship with patients.

How EHR affects patient engagement

The study quizzed doctors on their perceptions of the impact EHR had on patient engagement levels.  It found that doctors were often anything but complimentary about them, citing higher levels of burnout and a depersonalization of their work.

“Physicians who are burnt out provide lower-quality care,” the authors say. “What this speaks to is that we, as physicians, need to demand a rethinking of how quality is measured and if we’re really getting the quality we hoped when we put in EHRs. There are unintended consequences of measuring quality as it’s currently being done.”

What’s more, the poor communication EHR can often ensure can reduce the effectiveness of treatment plans, with patients less likely to engage in follow-up visits.  Despite this however, doctors appreciate that EHR can provide numerous benefits, and are undoubtedly here to stay.

Perhaps lessons can be learned from the relative minority who thought that EHRs did not undermine their abilities.  For instance, one clinician described how they used a medical scribe to handle the data entry aspect of visits.  This was an interesting contrast to the normal approach, which was to do a significant amount of data entry at home.

Perhaps hope is at hand with the improvements being made in voice-to-text technologies that are capable of annotating notes from the verbal conversations taking place during a consultation.  With doctors happily accepting the benefits of EHRs in terms of things such as the ease with which patient histories can be called up or the improvements in communication they can deliver, the main sticking point seems to be the difficulties inherent in imputing data to the systems in the first place.

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