Is Physician EHR Good For The Patient Experience?


EHRs where designed to improve the care experience for providers and patients. Providers and patient seem to have different opinions as to the impact on the patient experience, a recent study published in Annals of Family Medicine found.

The EHR is intended to promote safe, efficient, and high-quality medical care, the researchers wrote. However, some have previously described it as a “third person” in the examination room. It is implied that EHR use can change a healthcare practitioner’s eye gaze, posture, and attention given to patients during clinical encounters,

“Entering health information, placing electronic orders, and retrieving results can be distracting to patients and practitioners,” Ellen C Meltzer, lead study author and internal medicine specialist at Mayo Clinic-Phoenix, and colleagues wrote. “When practitioners focus on their computer, dialog is easily disrupted and can lead to gaps in communication and patients feeling unheard.”

The survey of nearly 60 clinicians and 1,000 patients evaluated the impact EHR use has during face-to-face visits in the primary care setting.

Providers all used the same EHR and had computers with monitors that could be positioned to face the patient.

The findings indicated , EHR use appeared to affect the provider experience negatively. Almost 79 percent of providers felt they had less eye contact when using an EHR system during a patient visit.

EHR use also seemed to impact providers’ ability to listen to patients, with greater than 53 percent of providers stating that they think they listened less carefully during an encounter. Also, 62 percent said EHR use made the visit less personal overall.

EHRs is supposed to improve care quality, care coordination, and communication of patient information. However, providers rarely reported positive aspects of the EHR with their patients.

Additionally, fewer providers than patients agreed that the computer improved patients’ understanding of their health.

Two-thirds of providers felt that patients thought EHR use made the encounter a negative experience, but the survey data indicated the opposite in some cases. Most patients in general had a favorable experience with the practitioner use of the EHR during their clinical encounter.

Almost all patients reported that physicians maintained enough eye contact during the visit and listened carefully.

Additionally, nearly 87 percent of patients disagreed that their providers focused less on them due to technology.

Overall, more than 91 percent reported that clinician EHR use made for a positive experience.

Researchers indicated that instead of focusing on the patient experience, focus on the misperceptions of care involving EHR and address the need for organizations to focus on the increasing rates of clinician stress and burnout related to patient data documentation.

Studies have suggested that the rise in EHR workload is linked to clinician burnout.

“Arguably, the primary drivers of burnout for physicians have been related to electronic health records and overwhelming inefficiencies in clinical practice that significantly and negatively impact workflow and patient care,” experts wrote in a Journal of the American Medical Informatics Association (JAMIA) study. “Physicians experience high fatigue with short, continuous periods of EHR use, which is also associated with inefficiency of EHR use (i.e., more clicks and more time) on subsequent cases.”

As provider burnout increases, the likelihood of providers leaving their organization is greater, suggesting that addressing the problems of burnout could help mitigate turnover.

By prioritizing health data interoperability and user-centered EHR design, EHR vendors can tackle administrative burdens contributing to clinician burnout.

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