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Industry Tries To Steamroll Physician Complaints About EMR Impact On Patient Face Time

Posted on June 9, 2015 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 FierceHealthcare.com 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.

Some doctors — and a goodly number of consumers, too — argue that the use of EMRs inevitably impairs the relationship between doctors and patients. After all, it’s just common sense that forcing a doctor to glue herself to the keyboard during an encounter undercuts that doctor’s ability to assess the patient, critics say.

Of course, EMR vendors don’t necessarily agree. And some researchers don’t share that view either. But having reviewed some comments by a firm studying physician EMR use, and the argument an EMR vendor made that screen-itis doesn’t worry docs, it seems to me that the “lack of face time” complaint remains an important one.

Consider how some analysts are approaching the issue. While admitting that one-third to one-half of the time doctors spend with patients is spent using an EMR, and that physicians have been complaining about this extensively over the past several years, doctors are at least using these systems more efficiently, reports James Avallone, Director of Physician Research, who spoke with EHRIntelligence.com.

What’s important is that doctors are getting adjusted to using EMRs, Avallone suggests:

Whether [time spent with EMRs] is too much or too little, it’s difficult for us to say from our perspective…It’s certainly something that physicians are getting used to as it becomes more ingrained in their day-to-day behaviors. They’ve had more time to streamline workflow and that’s something that we’re seeing in terms of how these devices are being used at the point of care.

Another attempt to minimize the impact of EMRs on patient encounters comes from ambulatory EMR vendor NueMD. In a recent blog post, the editor quoted a study suggesting that other issues were far more important to doctors:

According to a 2013 study published in Health Affairs, only 25.8 percent of physicians reported that EHRs were threatening the doctor-patient relationship. Administrative burdens like the ICD-10 transition and HIPAA compliance regulations, on the other hand, were noted by more than 41 percent of those surveyed.

It’s certainly true that doctors worry about HIPAA and ICD-10 compliance, and that they could threaten the patient relationship, but only to the extent that they affect the practice overall. Meanwhile, if one in four respondents to the Health Affairs study said that EMRs were a threat to patient relationships, that should be taken quite seriously.

Of course, both of the entities quoted in this story are entitled to their perspective. And yes, there are clearly benefits to physician use of EMRs, especially once they become adjusted to the interface and workflow.

But if this quick sample of opinions is any indication, the healthcare industry as a whole seems to be blowing past physicians’ (and patients’) well-grounded concerns about the role EMR documentation plays in patient visits.

Someday, a new form factor for EMRs will arise — maybe augmented or virtual reality encounters, for example — which will alleviate the eyes-on-the-screen problem. Until then, I’d submit, it’s best to tackle the issue head on, not brush it off.

What’s Next For Physician Tablet Use?

Posted on July 23, 2012 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 FierceHealthcare.com 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.

Not long ago, Manhattan Research released a study offering details on how doctors’ consumption of digital devices and media is progressing.  The survey, which surveyed 3,015 physicians in 25 specialties, looked at doctors who were online in the first quarter of 2012.

Among the most interesting — if not surprising — findings was that tablets have more or less officially hit the medical mainstream. According to the research firm, tablet use among doctors has nearly doubled since last year, hitting a whopping 62 percent in this year’s study.  You also won’t be shocked to learn that iPads dominate medical tablet use, in part due to their high-res screen and ease of  use.

Why the greater rush to adoption?  I think the following comment, which Monique Levy of Manhattan Research made to InformationWeek, offers a nice insight:   “It used to be that you had to solve the problems of security access, validation, and data security first and then adopt,  (but) what’s happened is that the system has turned upside down. We’re now at adoption first and solve the problem later.”

As Levy notes, the first wave of adoption has been driven largely by access to lower-risk information, and less for patient data. We can expect to another round of resistance when physicians are tethered to EMRs largely by tablets, she predicts.  I’d add that as long as there’s no native client physicians can use to access EMRs on the iPad, it will make things worse.

Given that resistance, maybe medical use of tablets will expand in other areas first. According to IT prognosticators and researchers at the Gartner Group, top medical uses of tablets also include waiting rooms, e-prescribing, diagnostic image viewing and appointment scheduling. (I’m amazed more practices aren’t doing the waiting room check-in thing.) Maybe one of these other areas will evolve breakout apps before doctors are really hooked up with patient data on their tablet.