Experts discuss why electronic health records must be redesigned
A focus on the design and end-user experience of electronic health records (EHR) is key to improving the practice of medicine for both physicians and their patients. Find out what five experts had to say about why improving EHRs must be a top priority.
What’s the problem with EHRs?
With the Medicare Merit-Based Incentive Payment System (MIPS) on the horizon, EHRs must be designed to work more effectively so the new system does not repeat the issues of the past.
“Constraints are interfering with the evolution of the technology,” said AMA President Steven J. Stack, MD. “The vendors have designed products to satisfy the government and its certification program but … do not fulfill the needs of the clinicians.”
“We have to help the technology blend into the background as a supporting role,” Dr. Stack said. “One of its central failures right now is that EHRs are the central actor in a play of people, and we need to get the people—the patients, the physicians and the other caregivers—back in the center of this performance.”
“Physicians spend too much time away from their patients and also continuing their work at home,” said Christine Sinsky, MD, AMA vice president of professional satisfaction. A study at the University of Wisconsin found that doctors spend 38 hours a month of their own personal time on documentation, with a peak on Saturday nights, Dr. Sinsky said. “I don’t know if that’s good for patients …. I want my doctor to love her job.”
Physicians often feel that their jobs have transformed from doctor to typist, Dr. Sinsky said. “In a courtroom, we don’t expect the judge or the attorneys to do their professional work … and [simultaneously] create the legal record of the proceedings, but we have asked that of our physicians. [In addition], we’re asking for a near verbal recounting of every detail that happened—and that’s not humanly possible.”
What does the future of EHRs look like?
Designing the future first requires a dream, which then becomes a reality through hard work and diligence.
“My dream for the EHR is to be able to provide the infrastructure, the technology to make it really, really easy for physicians to get back to the art of caring for the patient,” said Nancy Gagliano, MD, chief medical officer of CVS Minute Clinic. “Put in the pieces that let the system do the system kind of work, and let the physician be the doctor.”
Population health also has been an important part of the conversation about the future state of EHRs. Michael Wasser, CEO of BloomAPI, spoke of promise in this realm. “We’re going to see populations of people getting healthier en masse [and] living longer, more healthy lives,” Wasser said.
When reading current EHRs, “it’s almost like you have a scroll, and you have to read through the whole scroll to see what’s actually happened to this individual,” Wasser said. “There’s no index; you can’t look the thing up.” The ability to see this kind of information broken down into usable data for improved health outcomes will make a difference in the future, he said.