Healthcare News and Trends
How Doctors Can Learn to Love Their EMRs
May 30, 2018
By
Debra Wood, contributor
Although
technology abounds in the delivery of health care, the industry has lagged behind others in adopting electronic documentation. The federal government incentivized
the use of electronic health records (EHRs)/electronic medical records (EMRs),
which has created a transformation.
But not
all physicians have been happy about it.
“Technology
is not going away,” said Susan Kressly, MD, FAAP, a member of the American
Academy of Pediatrics Council on Clinical Information Technology and a
pediatrician in Warrington, Penn.
“[Physicians] have to embrace the
technology as a tool, and [it’s] not one they were trained to use when going to
medical school and their residency,” Kressly added. “The use of an EHR is an
afterthought or sidecar and not integrated into the educational process.”
A 2016
study in Mayo Clinic Proceedings linked physician burnout with the electronic health
records. Physicians often complain about the time it takes to document
electronically and how sitting at a computer draws them away from patients.
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“Doctors
complain bitterly about the hoops they have had to jump through to qualify for
the original PQRS [Physician Quality
Reporting System] or MIPS [Merit-based Incentive
Payment System]
program from the government,” said Michael Rivers,
MD, director of EMA (electronic medical assistant) ophthalmology
at Modernizing Medicine, an electronic medical record vendor in Boca
Raton, Fla. “That’s what doctors hate.”
Kressly said she thinks newer
physicians experience less angst about electronic health records than
established physicians. Doctors tend to view the EHR as a glorified Word
document rather than looking at how the tool can help them, she added.
“Where they really struggle is
in documenting, and they miss the bigger picture, which is, ‘What information
can I get from this tool and interact with this tool to get more robust
information to help take care of my patients?’” Kressly said.
The
additional information available can improve patient care. Most electronic
medical records can provide immunization records and whether a patient has had
a mammogram or other screenings on schedule. But Kressly said physicians are
often reluctant to use such information.
“The
case for return on investment is there if you look at the broader picture and embrace
the tools given to you,” Kressly said.
How physicians can maximize EMR
benefits
Doctors
and electronic medical records can prove beneficial to patient care and the
bottom line.
Kressly
recommends customizing EMR templates to “think like you do.”
To
learn to love your EMR, Kressly recommends taking the time to truly learn to
use it and continuing to learn through users’ conferences or forums or release
notes as updates are added. Physicians, she said, tend to think it should be as
easy as using their phone.
“Practicing
medicine is not as easy as making a phone call, it takes practice, and you have
to make time to learn the tool,” Kressly advised. “It takes practice. And the
patient expects you to know how to use the tool.”
Additionally,
patients or office staff can enter some of the information in an EMR. Many
physicians hand a patient a tablet to enter information, such as medications
taken or allergies, into the record.
“We
need to turn some of this into team-based care, and the patient is part of the
health care team,” Kressly said. “Nurses can do medication reconciliation, the
allergy list or changes to the family and social history.”
Patient
messaging has eliminated playing telephone tag. The physician also can provide
additional information to patients on the patient portal, saving office visit
time.
“E-prescribing
has been a huge gain,” Kressly said, explaining that it has eliminated
handwriting issues.
“Doctors
do not get laughed at any more for handwriting, because none of us have to
write,” Rivers added.
Upgrading an EMR system
Many
physicians initially experienced problems with electronic medical records and
are now moving to newer, more sophisticated systems. About 50 percent to 60
percent of Modernizing Medicine’s clients are upgrading to a new system.
“A lot
of the early systems involved typing,” Rivers said. “Physicians had to use
them, because there was nothing else available.”
Modernizing
Medicine is tailored to specific specialties and workflow in different
practices. Information can be entered on an iPad and is presented in a way that
is easy for the physician to enter it.
Then
physicians can pull reports with information about the most cost-effective and
successful treatments.
An
electronic record gives you “an incredible database, where you can get to
information quickly,” Rivers said. “Our goal is to do [analytics] in real time
in the examination room.”
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