Wednesday, July 6, 2016
Wisdom Wednesday: Doctors Swamped by ‘E-Medicine’ Demands
Doctors say they’re drowning in electronic paperwork, feeling burned out and dissatisfied with their jobs thanks to countless hours spent filing our computerized medical forms, researchers report.
Electronic health records are a cornerstone in the effort to modernize medicine. But, new systems designed to chart a patient’s progress and instruct their future care have proven to be very time-consuming, the study found.
“While some aspects of electronic records can improve efficiency, computerized physician order entry is a major source of inefficiency and clerical burden for physicians,” explained lead author Dr. Tait Shanafelt, a Mayo Clinic hematologist and oncologist. “Tasks that used to be accomplished with a verbal or written order in less than 30 seconds can now take more than five minutes.”
As a result, physicians using these electronic records reported higher rates of burnout and increased frustration with the amount of computerized paperwork they must do, Shanafelt and his colleagues found.
“Physician burnout has been linked to decreased quality of care and medical errors, as well as an increase in the likelihood physicians will cut back their work hours or leave the profession,” he said.
The findings were published June 27 in the Mayo Clinic Proceedings.
Recordkeeping is the most arduous aspect of my job. I really don’t like doing it. I would much rather spend my time testing and counseling patients then creating a record of the act. However, being able to review that data with a couple of key swipes before, during or after an office visit with a patient is an invaluable tool for me.
I started keeping electronic records in the mid-nineties as the requirements for recordkeeping became more stringent every year. The first program I used ran on the DOS system. On January 1, 2000 my system ran true to the predictions and crashed. All the data was still in the drive; I just couldn’t access any of it. Fortunately, I was able to print all of it out and have several bound volumes of paper notes from the 1990s stored in cardboard boxes. It has little or no value but I am required to keep all those notes.
The program I use today is much more sophisticated. It is infinitely programmable and I spent a lot of time up front creating narratives that I can plug in with a click of the mouse. Although the data is all coded for my eyes only, I can convert any entry to Microsoft word with a couple of key strokes. This allows me to send reports to other physicians or even give my patients a written review of their office visit with me with little effort.
My office staff does not have access to my patient files, nor do I transmit them electronically. I attach the word document(s) to an e-mail or fax. I suppose a good hacker could get at my patient records, but they would be hard pressed to understand the coding. Beyond name and date of birth, there is no identity information in the files. I stopped asking for social security numbers many years ago.
The Bottom Line:
The modern requirements of recordkeeping are undoubtedly a source of burnout. However, physicians can minimize the effects by researching and adopting good software, then take the time to master the programming. In the end, it’s much easier and faster than paper records and provides accurate detailed data that improves health care.
Source: June 28, 2016 National Institutes of Health