Clinicians criticize poor workflow, interoperability of EHRs

Clinician organization leaders aired their grievances about electronic health records and the Meaningful Use program Wednesday at the eHealth Initiative's annual conference in the District of Columbia.

American Medical Association President Steven Stack (pictured), American Nurses Association President Pamela Cipriano and American Academy of Physician Assistants President Jeffery Katz all shared their thoughts on the tools and the program, noting that while they understand federal officials weren't purposely trying to hamstring providers, workflow and morale have suffered.

"None of us … want to be the whiners and the complainers, we really, really don't," Stack said. "But we are very frustrated. … If we don't tell you what it's like, then there continues to be a propagation of this disconnect. I think there are a lot of people who think they are providing tools that are awesome for us. But they're not awesome in their current iteration, the way they're affecting what we do, and it's burning out our professionals."

Cipriano specifically identified poor workflow as a key concern, saying that federal regulations force nurses and other providers to waste time trying to both implement and navigate poorly built systems.

"While everyone was so busy trying to get their systems in place for Meaningful Use, we kind of forgot that the systems are intended to improve quality," she said. "They're also intended to make the workflow better instead of just automating lots of old pieces of paper and lots of old checklists and lots of silos of communication. We've created multimillion-dollar systems that may have seen their best days 20 years ago."

Now, Cipriano said, there's a huge dilemma.

"How do we sort of right turn the systems that we have to really produce the kinds of results and give us the information we want, and reduce the burden of data entry?" she said.

Katz lamented that team-based coordination is completely lacking in current systems, saying it's expected that "checkbox" information from one EHR will be sent to another, but the reality is something different.

"That doesn't happen because the EHRs don't connect; they don't talk to each other," he said.

That, Katz said, results in time wasted trying to track down information, or worse, increased costs to a patient's care due to repeated testing.