Doctors' 10 Biggest Mistakes When Using EHRs

Kenneth J. Terry, MA


May 01, 2013

In This Article

Keeping Both Paper and Electronic Records

Mistake #9: Creating "Shadow" Paper Documents

A recent study of physicians' EHR "workarounds" found that some doctors who feel uncomfortable with EHRs create paper "shadow" charts.[2] Doctors use these documents to track patient progress or as guides to medical decision-making, believing that they're more accurate and up to date than the EHR information.

Such an approach is understandable, especially if you have an unsatisfactory EHR. But maintaining both paper and electronic records can lead to other problems, such as missing information in one or the other or both.

"Once a patient record has been converted to the EHR, that should be the official document," says Rosenberg. "Having 2 charts is fraught with potential problems."

Another workaround, scribbling notes on pieces of paper, usually results from an IT person configuring the system without input from clinicians, Nelson says. If the EHR prompts and messaging system are set up correctly, there shouldn't be any need for Post-it® notes. She cautions doctors not to use regular interoffice email. Not only is such a system insecure, but it's also not tied to the patient record, she says.

Mistake #10: Accepting Inefficiency as the New Status Quo

What doctors fear the most about EHR adoption is that they will lose productivity for a certain period, or maybe forever. In fact, Medscape's 2012 EHR Report, in which physicians ranked the top EHR systems, showed that 32% of the respondents had not returned to pre-EHR levels of productivity, compared with 20% in 2010.

But the most unfortunate doctor response to this fear is to give up trying to be productive, Mark Anderson says. "Before, they were spending 2 minutes documenting, and now they're spending 10 minutes documenting. And they realize they're seeing 5-6 fewer patients a day. But they just say, 'Well, I have to do it that way.' They kind of give in to the idea that they're going to see fewer patients and make less money. But it doesn't have to be that way."

Among Anderson's recommendations: Don't try to enter all the data, and see what your colleagues who have EHRs are doing and what works for them.

An EHR may be a pain in the neck to learn how to use, and some things may take longer, but it needn't sink your practice. Follow the recommendations of experts, be proactive, and learn new ways of doing things if you want to succeed. Above all, avoid blaming the software for all your problems. Perhaps there's something you need to do to make it work better.