Med students need more access to EHRs

Medical schools should allow students to use electronic health records more so that they can become more competent with them, according to a new editorial published in the Annals of Family Medicine.

The editorial, written by the Association of Departments of Family Medicine's Education Transformation Committee, expresses concern that many medical schools restrict or bar student access to EHRs due to fears about attribution of note ownership, use of copy-and-paste functions, billing and patient safety.

However, medical students who lack adequate practice with EHRs may have a harder time achieving 11 of 13 Core Entrustable Professional Activities for Entering Residency described by the Association of American Medical Colleges.

Moreover, the associated problems go beyond the issue of learning how to use an EHR itself. Aspiring physicians also need to know how to elicit medical histories while recording into the EHR, how to use the population health management functions and safety reminders, and how to pay full attention to the patient.

"To fully prepare medical school graduates to assume roles of increasing responsibility and leadership in modern healthcare systems requires competence in patient-centered EHR use," the authors write. "For this to happen, all medical students should have access to the EHR that is based on educational need as opposed to risk aversion. We are confident that this can be done in a way which enhances education without compromising patient safety or third party regulatory requirements."

Physicians have long complained that EHRs create workflow problems and reduce patient/physician interaction. Studies have found that EHR use reduces direct patient care and fragments workflow time, even among medical residents, which can adversely affect their education and training.   And while, arguably, medical students and residents may view EHRs more favorably than older physicians due to their familiarity with technology, even they do not accept EHRs universally.

To learn more:
- read the editorial