EHR use can cause docs' skills to diminish

While electronic health records may lessen physician workloads, save time and improve patient care, adapting to the technology can lead physicians to perform in a more standardized, compartmentalized and routine way, eventually causing them to lose some of their clinical decision making and other skills.   

That sobering news is from a new study published in the Oct.-Dec. 2011 issue of Health Care Management Review, which found that EHRs may remove critical aspects of physician discretion in everyday work. Essentially, some providers wind up relying more blindly on information from the technology, such as guidelines, rather than their own knowledge and experience, ultimately leading to a "deskilling" process.  

The study interviewed 78 primary care physicians, who reported that reliance on EHRs increased the cutting and pasting of notes, causing records to be less reliable. In contrast, paper records forced physicians to use a certain amount of unique verbiage, as they had to give more consideration to the quality of information in the note.

The study found that this deskilling decreased clinical knowledge, lowered levels of patient/physician trust, applied one-size-fits-all medicine and decreased decision making confidence. The deskilling was "subtle" and partially dependent on the manner in which physicians chose to adapt to the opportunities offered by the technology, according to the study. 

"Physician deskilling is important to focus upon because understanding the intensity and significance of deskilling outcomes helps health care organizations better assess the relative cost-benefit of adopting different types of innovations in the first place," said study author Timothy Hoff, an associate professor of Health Policy and Management from the University of Albany School of Public Health.

To learn more:
- here's the study
- check out this blog post on the study

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