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Doctors: EMRs Can Be Quality Obstacles

Posted on October 15, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Many doctors believe that today’s EMRs are difficult to use and stand in the way of quality care at times, according to a new RAND Corporation research report covered by Healthcare IT News.

The RAND report comes from a project, sponsored by the American Medical Association, which was designed to identify what influences doctors’ professional satisfaction.

To research the report, RAND surveyed 30 physician practices in six states–Colorado, Massachusetts, North Carolina, Texas Washington and Wisconsin. RAND researchers also visited each of the practices on site, conducting in-depth interviews with 220 doctors, medical administrators and allied health professionals to see what drives doctors’ satisfaction with their work lives.

One key finding of the report was that being able to provide high-quality care is a primary factor in job satisfaction for physicians — and that anything which hinders them from doing so is a source of stress. And one critical factor that doctors feel impedes their ability to deliver good care is the requirement to use EMRs, Healthcare IT News notes.

Doctors who responded to the survey told RAND that current EMR technology gets in the way of face-to-face discussions with patients, demands that physicians spend too much time on clerical work and lowers the accuracy of medical records by encouraging the use of template-generated notes, according to Healthcare IT News.

What’s more, doctors told RAND that they’re unhappy that EMRs have been more costly than expected, and that the lack of interoperability between various EMRs has been a major frustration, as  it keeps them from easily sending patient data where it’s needed and when it’s needed.

Medical practices are trying to reduce doctor frustration by hiring staffers to perform many tasks involved in maintaining electronic records. And practices are attempting to improve physician satisfaction in other ways, such as giving them more independence in structuring clinical activities and allowing more control over the pace and content of the care they provide.

Still, it’s telling that as many as one-fifth of practices might switch EMRs, searching for an system that solves problems rather than creating new ones.  Whatever practices are doing to help physicians achieve satisfaction with their current EMR, it doesn’t seem to be working very well.

EMRs and the Paperless Medical Office

Posted on October 31, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

From the American Medical Association comes a recent story on EMRs and the paperless medical office. I think it touches quite effectively on the issue facing medical offices today – transitioning new patients to the new EMR has proved a lot easier than turning older paper records electronic. In one of my earlier posts, I’d written about this topic. This article provides some clever strategies in identifying which paper records to convert earlier than others.

Among the points discussed:
EMR use does not equal paperless: And yet, these two ideas somehow seem conflated in people’s minds. A doctor I spoke to recently said he had assumed that the EMR vendor would convert older paper records to electronic as part of the EMR purchase package. Well, the vendor might – for a fee. Electronic conversion ranges from simple paper scans to character/word recognition. For truly rich use of your data, say for report generation purposes, you’ll want something that populates a database. In fact, “data transfer probably is going to be a significant line item in the EMR budget.”

Not all data is equal: Having an EMR doesn’t mean that every little scrap of paper from the patient’s records needs to go into it. Doctors can make the call on the kind of data that they find most useful. It would however need some amount of planning and insight, not to mention time, to make this happen. What’s important depends on specialty as well.

Not all patients are equal: If a small proportion of patients you see tend to be the ones that come for repeat consults, it might make more sense to get the entirety of their paper records into the EMR.

Don’t make a beeline for the shredder immediately: Really, this should be self-intuitive. Unless you’re sure that every important piece of information you need has been transferred to the EMR, and the EMR data matches what’s on paper, don’t shred the patient’s records.

The only real quibble I have with the article was where it mentions that one company found that “having the doctors enter the data ensured the integrity of the information and helped them learn the new system.” Seriously? Have your $200+ per hour physician enter older records into an EMR, when you can get a temp or third-party vendor to do it for a fraction of the cost?

The statistics at the end of the article are quite interesting. The first statistic is especially encouraging.

A survey of 200 health IT professionals found that hospitals are taking varied approaches to digitizing their records. (Respondents could give more than one answer.)
49% have scanned what they need and stayed within their budget.
23% are within budget but still have a backlog of records to scan.
54% are scanning records onsite.
29% are using a centralized scanning location.
72% are relying on full-time employees to scan.
9% are using third parties.
6% are using part-time staff.
44% are not explicitly measuring the effectiveness or productivity of their scanning process.
58% plan to shred paper records once scanning is complete.
38% plan to store paper files in onsite records rooms or offsite storage facilities.

Source: Survey by information management company Iron Mountain, July