Docs cling to paper, EHR workarounds

Providers continue to use "workarounds" to deal with perceived inadequacies of their electronic health records, according to a new study in the Journal of the American Medical Informatics Association.

Current EHRs require clinicians to change the way they work and contain design flaws, such as difficulty in finding data and complex order entry processes. As a result, they often use workarounds, such as paper reminders or overriding alerts. However, these workarounds can pose a threat to patient safety, according to the study's authors.

The researchers, from the Indiana University Center for Health Services and Outcome Research in Indianapolis and elsewhere, used direct observation in 11 primary care outpatient clinics of three benchmark institutions experienced with EHRs to identify ways professionals were using or circumventing their EHR to complete their work. They found that clinicians used similar awareness, memory and efficiency workarounds at all three institutions, even though they each used different EHR systems, suggesting "consistent weaknesses" in EHRs. 

The researchers suggested that existing EHRs are not adequate to support the needs of providers and that EHR developers may want to consider better design to improve EHRs. They also suggested that "[i]t might be unrealistic to expect that EHRs will ever eliminate the need for user-created, paper-based cognitive support." 

Other studies have revealed deficiencies in EHR design and the resulting frustration on the part of providers, as well as concerns that such shortcomings will cause patient harm.

To learn more:
- read the study abstract