Electronic Health Records/Electronic Medical Records – Clinician Well-Being Knowledge Hub

The Future of Electronic Health Records

NAM — Thu, 19 Sep 2019 19:45:18 +0000

The following is a white paper discussing the future of electronic health records. What was originally created in efforts to make the transferring of health data more efficient, has now become burdensome to doctors and nurses and contributes to burnout. Significant change is needed in this field as EHRs are expected to serve as the backbone of information in healthcare. The paper offers a road map to integrating systemic change by creating a vision for the year 2028 of what a healthcare system would look like with a fluid movement of information and state-of-the-art technology. It discusses the current state of EHR’s and its inefficiencies, along with suggested action points for medical practices, payers, and regulators to address this problem.

Trying To Put A Value on the Doctor-Patient Relationship

NAM — Thu, 15 Aug 2019 20:42:29 +0000

The question of what the role of a primary-care physician should be, and how it should be valued, is becoming increasingly important in an age of digitized health information. In the following article, published in New York Times Magazine, Kim Tingley highlights David Meltzer, an economist and a primary-care physician at the University of Chicago, who may be the first and only researcher in the country trying to quantify that relationship’s value in a randomized clinical trial. Through vignettes of Meltzer’s studies, as well as her own personal relationship with her family’s doctor, Tingley emphasizes the significance of the singular connection for both the physician and the patient.

Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?

NAM — Thu, 15 Aug 2019 20:40:55 +0000

Published in the Annals of Internal medicine, the following article discusses the impact of electronic health records (EHRs) on physician’s interaction with patients and on clinician burnout. Although EHRs have great potential to improve care, they may also have perverse effects. Some studies suggest that U.S. physicians now spend as much time on “desktop medicine” (interacting with the computer) as they do face to face with patients. Providers must divide their attention between patients and the EHR, compromising patient–physician relationships. Although few physicians support reverting to paper, there is a growing sense within the medical community that the EHR is driving professional dissatisfaction and burnout.

How Tech Can Turn Doctors into Clerical Workers

NAM — Thu, 15 Aug 2019 20:31:15 +0000

The following article, published in The New York Times Magazine, examines the threat that electronic health records and machine learning pose to physicians’ clinical judgment–and their well-being. Although the EHR has reduced medication errors, made notes legible, and combined laboratory and imaging information, it was never built with any understanding of the rituals of care or the user experience of physicians or nurses. True clinical judgment is about using human skills to understand the patient’s trajectory in life and in disease, as well as the nature of the patient’s family and social circumstances.

The Burnout Crisis in American Medicine

NAM — Thu, 15 Aug 2019 20:30:00 +0000

The following article, published in The Atlantic, explores the contribution of electronic medical records and demanding regulations to a historic doctor shortage. For many doctors, attention is often consumed by challenges of coordination rather than patient care, and patients will often experience delays not for any medical reason, but simply because of an inflexible computer system and a poor workflow. The increasingly high demands of regulations and operations of medicine consume doctors’ practice, and leads to burnout and high turnovers. A health-care organization’s success, in the years ahead, will depend on its success at delegating responsibilities among physicians and non-physicians, training the non-physicians to do their work independently, and empowering everyone—not just doctors—to shape a patient’s care and be accountable for the results.

We’re a Bunch of Expensive Financial Clerks

NAM — Thu, 15 Aug 2019 19:16:09 +0000

Brent C. James, MD, MSTAT, explains an experimental next-generation electronic medical record that uses activity-based design. Like an electronic clinical scribe, a doctor can talk about what he or she is doing, and the computer system captures it and coverts it into automatable computable data. The original intent of EMRs was not financial, yet the current iteration is used to generate maximal fee-for-service billing, and that’s the reason physicians spend 2 hours at a computer for every hour they spend with patients. According to James, the system currently serves “a bunch of very expensive financial clerks” and should be redesigned for physicians.

8 in 10 Doctors have Experienced a Cyber Attack in Practice

NAM — Wed, 14 Aug 2019 20:44:04 +0000

Physicians, overwhelmingly, are finding themselves the target of cyber attacks due to an increasingly connected and complex digitized health care system. Out of 1,300 physicians surveyed, 83% have experienced a cyber attack of some type. Major concerns include malware, disruption of practice, and theft of electronic patient health information through health care fraud.

Counting the Costs: U.S. Hospitals Feeling the Pain of Physician Burnout

NAM — Wed, 14 Aug 2019 20:39:07 +0000

The following article, published in U.S. News & World Report, briefly summarizes the causes of burnout such as the burden of data entry on electronic health records, and the costs of clinician burnout on well-being, efficiency, patient safety, and economics. It also introduces the early initiatives taking place around the United States to combat burnout.

Teaching Physicians to Get a Break on a Burdensome Task

NAM — Thu, 25 Jul 2019 13:57:45 +0000

The following article reports on the Center for Medicare and Medicaid Services’ new policy, which eliminates the need to re-do medical students’ input to health records. Instead physicians will be able to refer to student notes as part of their own documentation. This rule will not only eliminate unnecessary work, but also emphasize the value of student’s input into the health record.

The Role of Medical Culture in the Journey to Resilience

NAM — Mon, 22 Jul 2019 18:52:55 +0000

The following article highlights retention threats of electronic medical records, external documentation required for oversight and billing, and divide between inpatient and ambulatory care teams to recruitment and retention in primary care. With context from a resilience workshop at a large primary care practice and a medical student studying for the United States Medical Licensing Examination Step 1, Beckman paints a picture of the cultural imperative to sacrifice self-care for productivity and individual achievement. The consequences are elucidated and recommendations are provided.