Filling in the EHR gaps so that patient charges can be billed properly is not only time-consuming, it detracts from meaningful face-time with patients.
For every hour of direct clinical care, physicians now spend an additional two hours completing EHR requirements and so-called desk work, according to a recent AMA-funded study published in the Annals of Internal Medicine (September 6, 2016).
An additional one or two hours is spent after work on unfinished EHR tasks.
Responding to the study’s findings, Dr. Susan Hingle of SIU School of Medicine warns that the demands of EHRs can put physicians at greater risk of professional burnout. Even worse, says Dr. Hingle, some of these doctors are at a significantly greater risk for depression and suicidal ideation.
Even medical students and residents are spending more time with their computers than with their patients, according to Dr. Caleb Gardner’s and Dr. John Levinson’s editorial in The Wall Street Journal (September 22, 2016). A 2013 study from Johns Hopkins showed that first-year [resident physicians] spent a meager eight minutes a day with each of their hospitalized patients while spending hours at the keyboard describing and quantifying those fleeting moments.
The shift away from meaningful time for patients is frustrating to physicians and patients alike. Senior physicians are retiring early because of the EHR, while young doctors feel the humanity draining from a profession to which many were drawn because of a desire to interact and connect with people.
Careful listening and undivided attention are important, and the incessant electronic reminders and check boxes that divert a doctor’s attention while the patient sits on the examination table are a distraction equivalent to texting while driving, and will end up hurting patients.
In its quest for market efficiency, contemporary medicine is losing its humanity, says Dr. Arthur Kleinman, a professor at Harvard University, buckling under the weight of massive, ill-designed electronic information systems (The Wall Street Journal, September 22, 2016).
Motivated by more than $30 billion in incentives, vendors have lined up happily to ride the wave, building EHRs that satisfy government requirements but make it increasingly difficult and less rewarding to care for patients, according to Jonathan Bush of Athena Health (statnews.com, September 6, 2016).
Although EHRs are here to stay, they must by simplified and refined in a way that will not distract from patient care. As stated by Drs. Gardner and Levinson: Doctors have an obligation to act with humanity toward patients and should insist upon the undivided attention to do so.