Stanford report urges medical practices to ‘junk the fax,’ focus on EHR training and workflows

In an ideal world, clinicians would have virtually no interaction with a patient’s EHR.

Instead, doctors and nurses would spend the majority of their time with patients and EHR data would be populated with “little or no effort.” Vital signs would be instantly uploaded by an automated assistant, artificial intelligence would offer personalized treatment options and relevant data would flow seamlessly through the rest of the system.

That’s the vision of EHRs in the year 2028 as described in a new report from Stanford Medicine based on input from industry experts that attended a June symposium hosted by the medical school.

It’s also a far cry from where the industry is today.

The report highlights what dozens of previous findings have already laid bare: EHRs haven't lived up to their expectations. But Lloyd Minor, M.D., dean of the Stanford University School of Medicine, says there are “a lot of reasons to be optimistic” about the future thanks to new technologies, an emphasis on apps and shifting regulations that give patients control of their data.

“EHRs may soon serve as the backbone of an information revolution in healthcare, one that will transform healthcare the way digital technologies are changing banking, finance, transportation, navigation, internet search, retail and other industries,” the report states.

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For now, physicians are still battling a lot of headwinds. A survey of 521 primary care physicians conducted by The Harris Poll on behalf of Stanford found that 44% of doctors view EHRs as being primarily for data storage. And three-quarters said improving EHR interfaces to reduce screen time should be a top priority.

Part of that falls to developers to create systems with end users in mind and eliminate the need for manual data entry. Experts believe AI advancements will play a key role in consolidating data.

But the report argues that medical practices have an equally important role to play but shifting non-essential data entry to ancillary staff and increasing the number of digital scribes.

Training new physicians and updating existing physicians on technical changes is equally important. The report highlighted work by the University of Colorado Health, which created an 11-person “Sprint” team to address physician burnout associated with EHRs.

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“Organizations with the least physician burnout are the ones where physicians have had longer training sessions,” C.T. Lin, M.D., chief medical officer at University of Colorado Health, said in the report. “And it’s not about how to use the EHR. It’s about how we provide care, with the EHR as one of the main tools.”

Another call to action for medical practices: “Junk the fax,” and embrace electronic communications like patient portals. That's a movement that has the backing of federal officials. Centers for Medicare & Medicaid Services Administrator Seema Verma has called for an end to physician fax machines.

“For the 30% to 40% of American practices that are unwilling to give up the fax machine and are unwilling to receive electronic payments, perhaps there has to be a culture shift,” Terry Gilliland, M.D., senior vice president and chief health officer at Blue Shield of California, said in the report.