Physicians Overwhelmed by Messaging From Electronic Medical Records
MedicalResearch.com Interview with: Matilda W. Nicholas, MD, PhD
January 29, 2018
MedicalResearch.com: What is the background for this study?
Response: I have found many physicians overwhelmed by the electronic messaging feature in Electronic Health Record systems (EHRs). I found there was very little published about this phenomenon, particularly for specialists. So, we set out to take a look at the volume and effect these systems have.
MedicalResearch.com: What are the main findings?
Response: We found that, on average, clinicians receive 3.24 messages per patient visit, for an average of about 50 messages per full day of clinic. The number of messages also correlated with poor reported work life balance for dermatologists.
MedicalResearch.com: What should readers take away from your report?
Response: As previous studies have shown, physicians are spending much more time in non-direct patient care and less time with patients. This is bad for everyone involved. Targeting methods to decrease this burden would be important in improving patient care and physician wellbeing ... We are planning on examining the messages sent directly from patients more closely, hoping to target higher risk patients to decrease post and inter-visit messaging.
As at my Jan. 28, 2018 post "Medical Economics: Highly experienced physicians lost to medicine over bad health IT" at http://hcrenewal.blogspot.com/2018/01/medical-economics-highly-experienced.html and many, many others, cybernetics are proving a distraction from - and actually a deterrent to - the practice of good medicine.
With the increasing outcry of physicians and nurses against EHRs and the oppressive demands the systems place on them, and the burnout these systems cause (see the numerous posts on burnout at query link http://hcrenewal.blogspot.com/search/label/burnout), I'm increasingly of the opinion these systems are not fixable.
There is only so much that can be accomplished with surface changes to user interfaces, without substantive changes to physicians' work expectations.
The true problem that nobody seems to want to deal with - the proverbial elephant in the living room - is expectations of clinicians doing oppressive amounts of clerical work, in addition to their patient care responsibilities.
(Note that in this essay I am not addressing other critical drawbacks to this technology such as crashes, lack of security including growing record theft, ransomware attacks on EHR's, and so forth.)
Of course this will likely never happen, because it's an expensive labor proposition.