Docs 'stressed and unhappy' about EHRs

They complain that 'electronic systems are deeply problematic in several ways.'

While physicians recognize the benefits of electronic health records, they also complain that many systems deployed nowadays are cumbersome to use and often act as obstacles to quality care, according to a new report from RAND Corporation.

The study makes the case that being able to provide high-quality healthcare is a primary driver of job satisfaction for doctors, and that anything that hinders that ability is a source of stress. RAND officials say the findings suggest potential early warnings of deeper quality problems developing in the U.S. healthcare system.

"Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care," said Mark Friedberg, MD, the study’s lead author and a natural scientist at RAND. "If their perceptions about quality are correct, then solving these problems will be good for both patients and physicians."

The findings are from a project, sponsored by the American Medical Association, designed to identify influences on doctors' professional satisfaction – a snapshot of physician sentiment as the U.S. healthcare system moves toward new delivery and payment models.

Docs who were surveyed expressed concern that current EHR technology interferes with face-to-face discussions with patients, requires physicians to spend too much time performing clerical work and degrades the accuracy of medical records by encouraging template-generated notes, according to the RAND report.

In addition, they worry that the technology has been more costly than expected, and cited frustrations about poor EHR interoperability, which prevents the transmission of patient data when and where it's needed.

"Physicians believe in the benefits of electronic health records, and most do not want to go back to paper charts," said Friedberg in a press statement. "But at the same time, they report that electronic systems are deeply problematic in several ways. Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients."

Medical practices reported experimenting with ways to reduce physician frustration, according to the study. Some employ additional staff members to perform many of the tasks involved in using electronic records, helping doctors’ focus their interactions with electronic health records on activities truly requiring a physician’s training.

Researchers say that physicians reported being more satisfied when their practice gave them more autonomy in structuring clinical activities, as well as more control over the pace and content of patient care. Doctors in physician-owned practices or partnerships were more likely to be satisfied than those owned by hospitals or corporations.

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