We previously posted about Dr. Atul Gawande's: "Why Doctors Hate Their Computers". A recent Harvard Business Review article offers strategies for dealing with the most hate-worthy effects of Electronic Health Records (EHR) in the United States. All suggestions resonate with Dr. Gawande's reflection that our problems have more to do with people and processes than products or technology.
1. Standardize and reduce insurance-imposed documentation burdens
As observed by others, the same EHR blamed for burnout in some implementations is credited for satisfaction and retention in other settings. A better predictor of burnout appears to be documentation burden, whether paper or digital. There are huge reimbursement-related micro-documentation pressures in the United States. Whether these have a net-positive effect on health care, in addition to health care billings, is a key question. In any case, it is possible and desirable to deploy EHRs in ways that significantly reduce total informational burdens for physicians.
2. Improve EHR workflows
To the extent that EHRs replicate pre-existing workflows, a huge transformation opportunity is missed. When organizations pair improvement with implementation, many informational peeves are eased, not exacerbated. Process steps can be removed and pathways streamlined. Such optimizations, increase clinician satisfaction and contribute to the variability in reports of physician burnout.
3. Use EHRs to Leverage Innovation
When a digital health record integrates across the continuum of care, health information can flow more like a public utility... a dependable resource that consumer-facing innovations do not have to re-invent. The energy of innovation can shift from system to user. For example, dramatic improvements in the EHR experience follow release of mobile EHR Apps with guessable user interfaces. More importantly, mobility has stimulated release of standardized application interfaces (e.g., Epic's App Orchard) that innovators can use to produce even better user experiences. These reflect the peculiarities of end-user needs and preferences. It is exciting to contemplate innovation unleashed by health record standardization.
The original article is a quick read: