I’ve written previously about the apprehension many doctors feel towards the roll out of electronic health records (EHR), with many expressing concern that they are a considerable administrative burden and get in the way of high quality care.

It’s a conclusion echoed in a recent study from Yale University, which finds that many health care professionals think EHR systems lack usability and contribute to stress and burnout.  Indeed, whereas using Google was given an ‘A’ rating for usability, EHR systems were given a woeful ‘F’ rating.

“A Google search is easy,” the researchers say. “There’s not a lot of learning or memorization; it’s not very error-prone. Excel, on the other hand, is a super-powerful platform, but you really have to study how to use it. EHRs mimic that.”

Digital transformation

The transition to digital medical records grew apace after the 2009 Health Information Technology for Economic and Clinical Health Act, which saw some $27 billion in federal incentives awarded to help healthcare providers adopt the technology.

Such a rapid adoption resulted in understandable complaints from doctors who were unable to adapt quickly enough to the change.  This has contributed to an unhealthy situation whereby doctors often spend at least one to two hours on the EHR systems for every hour they spend with patients.

“As recently as 10 years ago, physicians were still scribbling notes,” the researchers say. “Now, there’s a ton of structured data entry, which means that physicians have to check a lot of boxes. Often this structured data does very little to improve care; instead, it’s used for billing. And looking for communication from another doctor or a specific test result in a patient’s chart can be like trying to find a needle in a haystack. The boxes may have been checked, but the patient’s story and information have been lost in the process.”

Role in burnout

As with any scenario whereby people are frustrated with the tools they have, the study reminds us of the significant contribution EHRs make to physician burnout.

Burnout is notoriously high in the medical profession, and ranks at least twice that of the population as a whole.  The researchers believe that poor usability of EHR systems play a significant role in that issue.  Indeed, there appeared to be a clear link between the rating doctors gave to their EHR, and their likelihood of experiencing burnout.

This problem appeared to be particularly pronounced in certain specialties, with dermatology, orthopedic surgery and general surgery especially likely to think badly of their EHR.

The researchers hope that by better understanding the thoughts of doctors towards EHRs, they will better be able to track the impact of technology on burnout, especially as the usability of EHRs improve.

“We’re trying to improve and standardize EHRs,” they conclude. “The goal is that with future work, we won’t have to ask doctors how they feel about the EHR or even how burned out they are, but that we can see how doctors are interfacing with the EHR and, when it improves, we can see that improvement.“