Last week, I lamented that there’s little progress when it comes to government rulemaking--that the government appears stuck, proposing many of the same requirements for the electronic clinical quality measures (eCQMs) in the new Inpatient Prospective Payment System that it proposed for the Meaningful Use program, even though some of them didn’t work and in some cases changed.
But it’s not only the government stuck in neutral. The private sector seems just as stuck on its own merry-go-round when it comes to electronic health records.
First, there’s a new study about EHR workarounds, which found them to be “common.” Physicians are still resorting paper crutches, such as sticky notes and faxes, in order to help them in their practices, even though they run the risk of inaccuracies and creating barriers to tracking information. For example, doctors are using paper memory aids because they can’t go back and find test result information in the EHR once it’s been reviewed; the massive number of intrusive alerts still creates an inefficient overload.
This is despite the fact that we’ve known for years that EHRs need to be redesigned to be more usable.
The authors recommended that future EHRs evolve to meet physicians’ needs. But why hasn’t this evolution already taken place? Why must so many EHR users still resort to personal workarounds?
Then we have the Mayo Clinic’s new study on EHRs and physician satisfaction. The study found that satisfaction with EHRs was still “generally low.” They still create undue clinical and clerical burdens, interruptions and distractions. Moreover, physicians had lower satisfaction and higher burnout rates, whether or not they liked their systems; it seemed that merely using an electronic system was sufficient to lower satisfaction and increased burnout.
But again, physician dissatisfaction with EHRs isn’t new. Why is it still so prevalent?
Why is everything so stuck? It’s like we’re in a time warp.
Granted, the industry has made progress in some areas, albeit slowly. We’re inching toward more data exchange, increased data analytics is improving research and more focus is being placed on health IT and patient safety.
But if the systems themselves are still unwieldy and problematic for the clinicians who use them, that’s a major, fundamental problem that must be addressed. These shortcomings are not new. Why are they getting short shrift? Is there no impetus to improve?
Most physicians are about to be channeled from the Meaningful Use program to MACRA and the Merit-Based Incentive Payment System (MIPs), with an even greater emphasis on health IT use. If EHRs are no better now than they were years ago, how can physicians hope to meet the technology requirements? And if they don’t, what does that mean for MIPS? For Medicare? For the doctors?
The industry must make some headway. All of health IT needs to advance if the move is going to succeed. - Marla (@MarlaHirsch and @FierceHealthIT)