Doctors' 5 Biggest Gripes About EHRs

Keith L. Martin

Disclosures

August 26, 2019

In the Medscape poll, nearly a quarter of doctors say that the added paperwork and charting required by their systems is the main way EHRs have decreased the quality of patient care they provide. A similar number of doctors note that entering data during the time when they are seeing patients is a close second.

5. EHRs Don't Interact With Other Systems

In our poll, one in five doctors also noted the lack of interoperability and various technical failures that hinder access to records as additional detriments to the systems they use.

CMS and independent groups, promising that patients can seamlessly access their medical records no matter where they receive care, have touted progress on interoperability for years. In February 2019, federal regulators unveiled plans to open the access and exchange of records for both patients and physicians. Those rules are expected to be finalized later this summer.

In the meantime, it's rare that systems from two different vendors can seamlessly interact and provide the needed information in the same digital fashion as booking an airline ticket or accessing one's bank account via smartphone.

Hoffman uses three different EHR systems in the three different clinics at which he works. The only way the three systems remotely operate together—as they can't communicate among one another—is the ability to support e-prescribing; each doing so in its own unique way. Although no EHR will pull all of a patient's medications if they are entered in different systems, Hoffman says it would be best to have that information available at the time of the patient encounter.

[EHRs] need to facilitate important communication between providers in different locations and using different EHRs. That's what is not happening...

"[EHRs] need to facilitate important communication between providers in different locations and using different EHRs. That's what is not happening in any of the software I see," he says. "It would be simple to do this, but part of the barrier is that there are a lot of sunk costs in the software as it is currently developed. It would be tremendously costly to change the coding."

Charles Stellar hears frustration from various healthcare stakeholders as president and CEO of the Workgroup for Electronic Data Interchange, a nonprofit authority on health IT. With membership from payers, physician groups such as the American Medical Association, the Medical Group Management Association, and others, Stellar says the dissatisfaction "is more than just a hum."

"You have huge hospital systems that may be able to sign on with an Epic or Cerner EHR [and share information], but for the small, individual physician, it's not the same at all," he says. "I see it with my own physicians...they are just at wits' end."

Here's What Physicians Do Like About EHRs

Three out of every 10 physicians in the Medscape poll say the biggest contribution of EHRs when it comes to improving patient care lie in the ability and ease of accessing patient information. E-prescribing was seen as another benefit by doctors as well as the ability for all members of the care team to easily access patient records. One in every 10 physicians, however, maintained that the computer systems have not increased the quality of patient care in any form.

Since 2004, Victor Wilson, MD, a solo pediatrician in Norman, Oklahoma, has used the same EHR system. Noting that he doesn't use the full range of services the system provides, Wilson says on most days he can get his notes done after patient encounters, use e-prescribing, and, overall, not feel hampered by the system.

Like other physicians, especially those in solo practice using a simpler EHR system, Wilson is less frustrated than his peers. When not forced to use a particular system in a particular way, physicians may feel less restricted by EHRs.

"I'm pleased with the product I selected and haven't found anything better that would make it worth changing," Wilson says. "They keep upgrading it, and when I call in, I still talk to someone who knows what they are doing and sticks with me until we solve the problem. So I'm happy with it."

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