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How Doctors Can Learn to Love Their EMRs

May 30, 2018

How Doctors Can Learn to Love Their EMRs

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.”

Related blogs:

Medical Scribes: A Physician’s Secret Weapon

3 Ways Social Media Has Changed Patient Care

Artificial Intelligence in Medicine

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