Katherine Rourke’s May 23 post over at EMRandHIPAA.com regarding why the majority of providers who try EMR systems revert back to SOAP notes within a few months was interesting. She wrote,
“When asked why they go back to paper, they confess that they find EMR’s very rigid; the logic forces them into a completely unfamiliar (and often inferior) approach to their patient encounter. Subsequently, the physicians either stay after hours to type and click their notes into the EMR or delegate the arduous task to a staff member. The comments I’ve heard from my referring physicians follow along these lines:
“I’ve been practicing medicine for 20 years… What do the people who designed this software know about practicing medicine that I don’t?”
“Why can’t an EMR learn how I practice instead of forcing me to assess my patient its way?”
“It seems the more we customize the templates, the more pull-down screens we create, making the system even more cumbersome.”
I had to quote liberally from Katherine here because she pretty nearly 100% nails the right sentiments. Notice how much of a me-me-me mentality is often present. I’ve posted on this a few times in the past. I, too, remember staying after hours to type notes when I used Epic as a resident, but that was because I was only seeing clinic outpatients half a day per week and didn’t have a lot of time to spend on figuring out the templates in the system (I think they were called smart phrases back then). I think it’s a learning curve that doctors are too lazy to try to learn, despite now having all the time in the world to do so — I see patients Monday through Friday, all… day… long. For me, the problem was solved by my actually investing the time to learn how to use the tools in the right way. Much like going through residency on a quicker and shorter timescale, this still can be a bit of a drag. It requires knowing if your ultimate goal is really to use electronic medical records successfully, or if you are just doing it for some incentive money. If you’re not engaged in the mission, then you will continue to complain about EMRs due to not really getting the point and buying in. When doctors finally get it and are happy and excited to use an EMR, I say welcome aboard!
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at doctorwestindc@gmail.com.
Very interesting take on it. No doubt it’s a challenge for many doctors to learn the new technology. Many have made it quite clear that they don’t have the time to learn the new system. Plus, they’ve become a vocal group of doctors that talk about EMR software too. A lot of the others that love their EMR and have learned their system don’t make their voices heard.
I wonder what they mean by don’t have the time. If it became a law mandate, I wonder what they would do?
[…] EMR reversions, ego stumbling blocks for doctors, and the MISSION! […]
EMR Reversions . . .
The observation ” …they find EMR’s very rigid; the logic forces them into a completely unfamiliar” was valid for early EMRs and sent many to the sidelines for several years.
Current day EMRs allow users to build workflows that mirror the way they like to process patients (no unnecessary steps, no unwanted steps), using agency or doctor preference forms (no more data/no less data than is wanted or needed to be collected).
And, the User Interface consists of a schedule of fixed time events and floating time events or to-do’s. That covers 100% of what people do in any workday. All patient clinical interventions can be launched from this UI.
The time to learn a system such as this for clinical work is a few hours (contrary to the learning curve for e-billing which can take a few days).
Anyone who is able to access their e-mail in MS Outlook is about 75% there (tasks post to an InTray, the user takes action, completed tasks clear out from the InTray)