More than six in 10 primary care physicians say electronic health records have led to improved patient care, generally and in their own practices, and that they’re at least somewhat satisfied with the digital documentation systems they use, according to a new Stanford Medicine survey (link to pdf) commissioned from The Harris Poll.
However, a majority of doctors also report frustration with how EHRs have affected their relationships with patients and with the amount of their time required by the systems; and seven in 10 doctors say the demands of electronic health records are a major contributor to physician burnout.
Presenting the survey Monday morning at Stanford Medicine’s EHR National Symposium, Dean Lloyd Minor, MD, said the conflicting findings signal a crossroads for a technology that has been widely used over the past decade, but has fallen short of its promise for innovation in clinical care.
“As the questions on the survey explored deeper and more complex areas, we noted a number of complexities. We noted that this approval of the EHR was nuanced and that there were many opportunities for improvement moving forward,” Minor told the symposium audience.
Today’s conference brings together leaders in patient care, technology, design thinking and public policy to explore ways for developing the potential of electronic records while reducing the administrative burden on doctors.
“We’re not going to solve these problems overnight," Minor told the symposium audience, "but I’m convinced the solutions are going to require people like all of you in this room together, coming together and thinking creatively about the future and working together to make sure that we address the challenges of today and succeed in meeting the opportunities of tomorrow.”
Stanford commissioned the online survey of more than 500 primary care physicians throughout the United States to provide a baseline of opinions and experiences with electronic records systems. Some results were surprising, Minor said.
Overall, physicians paint a negative picture of how EHRs have affected their daily lives. More than half report the systems detract from their professional satisfaction, and seven in 10 say EHRs have increased the total number of hours they work, taking away time they would be spending with patients.
Over the course of a 20-minute in-person patient visit, doctors estimate they spend 12 minutes interacting with the patient and nearly as much time — eight minutes — interacting with the patient’s digital record, on average. After the patient leaves, they spend an additional 11 minutes on the computer, according to the poll.
Though digital records hold the potential to help doctors engage patients in their care, make clinical decisions and work with patients to manage their conditions, more than four in 10 physicians say they feel the primary value is related to storing data.
In the short term, the poll finds, doctors favor changes that would reduce the amount of time they spend interacting with electronic health records. For example, more than seven in 10 want an improved user interface design.
Further in the future, physicians would like to see more sophisticated clinical capabilities in the EHR systems they use, including better predictive analytics for prevention, diagnosis and population health management. Additionally, a large majority — more than two thirds — want electronic health records that are better equipped to share information across different systems, a concept known as interoperability.
Minor said the finding indicates that doctors understand the clinical potential of digital records systems.
"They realize that we can dramatically improve the care we deliver to patients if we’re better able to derive information from the vast amounts of data that oftentimes sit trapped inside electronic health records," he said.
Photo of Lloyd Minor by Rod Searcey