RAND: EHR usability a 'unique and vexing' challenge to doc satisfaction

The RAND Corporation has released a new study warning that electronic health records worsen physicians' satisfaction, which in turn may adversely affect patient care.

The study, sponsored by the American Medical Association, evaluated data from 30 physician practices in six states, 28 of which used EHRs. Fourteen different EHR products were represented. 

The authors evaluated physician satisfaction, and determined that the "most novel and important findings" involved how EHRs affected the physicians' personal satisfaction. While most physicians like the concept of EHRs and how they enhanced remote access and electronic communication, their inadequate design and usability provided a "unique and vexing challenge to physician professional satisfaction" in areas such as increased time on data entry, interference with face to face care, interfaces that don't match workflow, poor health information exchange and a mismatch between Meaningful Use and clinical practice.

"The current state of EHR technology appears to significantly worsen professional satisfaction for many physicians--sometimes in ways that raise concerns about effects on patient care," the report's authors said. "Physicians look forward to future EHRs that will solve current problems of data entry, difficult user interfaces, and information overload.

"Our findings suggest including improved EHR usability among federal EHR certification criteria," the authors continued. "In addition, the Meaningful Use rules may not provide physicians with sufficient flexibility to match the needs of their practices--especially for those who do not provide primary care."

The report recommends, among other things, that better EHR usability should be an industry priority and that it would be helpful to reduce the "cumulative burden" of rules and regulations on physicians.

The findings mirror many other reports that physicians are still running into challenges with their EHRs that can have a significant impact on patient care. Only one-fourth of ambulatory providers believe that EHRs and Meaningful Use are having a positive impact on patient care; they also take up time that could be spent on treating patients.

To learn more:
- read the study (.pdf)

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