Doctors loathe their EHRs, right? Not these physicians

Amid the uproar about how hard electronic health records can be to use, a small contingency of doctors are saying the software has made them much better caregivers.
By Bernie Monegain
11:50 AM
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doctors and EHRs

Carolinas Medical Center

EHR dissatisfaction is rampant. Doctors complain about too many clicks and unusable interfaces, to name just two common gripes. Health IT pros and clinicians hear and read about these problems a lot. But the other side of the story -- physicians who say the EHR makes them better doctors -- is less-often told. 

“Yes, I love the EHR I use,” said James Legan, MD. 

Legan, an internal medicine physician in Great Falls, Montana, who credits the EHR for helping him to practice medicine more effectively, is not alone. Medical Group Management Association CEO Halee Fischer-Wright, MD, while perhaps less exuberant than Legan, said EHRs have considerable promise in the practice of medicine. And then there’s Jeffrey Cleveland, MD, a pediatrician at Carolinas HealthCare System.

[Also: Patients frustrated by lack of EHR data interoperability, Surescripts finds]

Cleveland even went so far as to say that implementing Cerner had an immediate and positive impact on his ability to care for patients. 

“I was a better doctor overnight,” Cleveland said. “Absolutely. There’s no question in my mind. I was a better doctor in March 2008 than I was in February of 2008 – because I instantly had data.” 


Jeffrey Cleveland, MD, a pediatrician at Carolinas HealthCare System

How EHR love came to Carolinas

When Cleveland started practicing medicine in 1994 at Charlotte Pediatrics Clinic in Matthews, North Carolina, there was no EHR system, and there wouldn’t be one for another 14 years.

The clinic is part of the sprawling Carolinas HealthCare System, which today operates 900 care locations in North Carolina and South Carolina.

The work of getting the health system’s Cerner EHR up and running started in 2008. Cleveland was part of the informatics team that helped launch the EHR in ambulatory clinics first, and later in acute care facilities.

[Also: Study: Two-thirds of hospitals bulk up staff to boost clinician EHR adoption]

Since then, he has become a champion of EHRs, working to help other physicians get the most out of the technology. Perhaps it’s payback of sorts for what, by his own account, the EHR has done for him – and his patients.

Cleveland paints a typical scenario he encounters.

He sees children who’ve been in the newborn intensive care nursery for two months – because they were born prematurely at 26-week gestation. They’ve been discharged on Monday, and he’s seeing them on Wednesday.

“I’ve got a two-month hospital stay that I can actually go back and look at,” Cleveland said. “All the problems are neatly categorized in a problem list. All the meds are in front of me. All the procedures are right there tabulated in one place, That’s a goldmine.”

These days, after having the EHR in place for a decade, the efforts at Carolinas HealthCare are all about optimization, better integration of tools in clinician workflow.

“One of the things I love about our EMR,” Cleveland said, “is that in the decade since we started using it, a lot of the vendors have come up with a mobile solution.”

Cleveland uses Cerner’s PowerChart Touch. It’s a mobile version of the electronic health record, which is available on Cleveland’s phone or on his iPad, and it helps him to be more productive and better engages his patients, he said. 


A screensnap of Amazing Charts EHR interface.

EHRs a boon to patients, too

EHRs are not just popular among doctors at large tech-savvy hospitals. 

In Montana, for instance, when Legan transitioned to the cloud-based Amazing Charts EHR and later added CRM from Updox, “it got even better,” he said. He now counts e-prescribing and e-faxing as vital.
 
Legan added that the technology enables quick coding after each patient visit. It’s easy to provide and easy to read. It’s much more effective than trying to find the information on the old paper superbill. 

“I couldn’t do any of this,” he said “if I had not transitioned from paper to EHR-CRM.” 

But the biggest benefit is the ability to display the patient’s record on a large screen, which Legan pointed out is an effective way to engage and coach patients at the point of care.

“Clinicians, who have figured out how to use their EHRs to build strong relationships and leverage data from their systems that intelligently inform their decision making, are role modeling the highest and best use of EHRs in a clinical setting," MGMA’s Fischer-Wright said. “Physicians who love their EHRs are those who have worked hard to make their EHRs work for them.” 

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com