I will be participating later this month in a “user group” discussion with my electronic health record (EHR) vendor, during which we will be able to share our thoughts on the technology so the vendor can determine next steps. I suspect that what my vendor wants to do and what I’m going to ask them to do will be slightly different—I’m going to tell them how difficult and frustrating using the EHR really is for physicians.
I know I’m not alone in my frustrations. A 2013 AMA study we conducted with the RAND Corporation looks at factors that influence physicians’ professional satisfaction, demonstrating that most of us find the current state of EHR technology to be lacking and cite the serious shortcomings of EHR systems as a major cause of professional dissatisfaction.
I’m an early adopter of this technology because I believe it can work. My office went paperless in 2002, so now I’m on my second EHR product. At this point, I know what I need to make using EHRs worth my time, and I plan to share these needs with my vendor.
- Searchable data. I don’t want to have to submit a ticket to my vendor to get actionable data that I want to use today. Six-month-old data is no good to me. I need a way to pull that information immediately.
- Interoperability: I need my EHR to allow me to import data without having to pay for expensive interfaces for every system with which I communicate or having to manually enter data.
- Quality guidelines. If we’re going to be asked to prove our adherence to quality measures, we need those guidelines built directly into our EHRs. That way, when we suggest a course of action, we know whether or not it adheres to quality guidelines, and can electronically prove our compliance.
- Better notes. In my system, the electronic notes aren’t really useful. There’s no easy way for me to input what the patient is saying at the time of their visit, my thoughts on the patient’s issues or what we plan to do. The information is mostly for billing purposes, not patient care.
We can share our feedback with our EHR vendors and let them know their systems need our input so they can work in a way that enhances the physician practice and the care we give our patients.
As part of our Professional Satisfaction and Practice Sustainability initiative, the AMA is developing a set of characteristics and recommendations to improve EHR usability, identifying opportunities to achieve these improvements, and determining a research agenda to advance the evidence base for increasing usability. We will be addressing the factors that lead to reduced productivity and increased frustration directly with the EHR vendor community.
But that’s not all. The AMA also is continuing our intensive advocacy to address the overly burdensome EHR regulations that require us to spend so much time in front of the computer. The AMA has achieved improvements to the meaningful use program, including extending Stage 2 of the program through 2016 and securing additional hardship exemptions to help physicians avoid penalties. We are pushing for a greater federal focus on making sure products can exchange data with one another and simplifying EHR certification so vendors can spend time developing innovative products and addressing physician user concerns.
The AMA is also developing educational modules that will give us the tools and information we need to be better EHR purchasers, implementers and users, regardless of our practice size.
Between physicians taking a lead role in shaping this technology and the AMA’s work in this arena, we’ll soon have systems that help—not hinder—the patient-physician relationship.
