Physicians speak out against EHR 'shackles' in JAMA commentary

Physician dissatisfaction with EHRs is not news at this point. Complaints about integrating the technology into practice and whether they add anything meaningful to the patient experience and care delivery process have been flying since the ONC first incentivized adoption. But after a few years into life with EHRs, physicians are able to pinpoint with more precision exactly what isn't working with the technology.

"At present, the spectacular effects of computers in science and in the secular world are not reflected in the EHR, which for physicians remains burdensome, all-consuming, and far from intuitive; this is not surprising, when the dominant EHRs are designed for billing and not primarily for ease of use by those who provide care," the authors of a commentary in the Journal of the American Medical Association wrote this week.

Their criticisms are in line with much of the oft-cited shortcomings of EHRs, such as their potential to create alert fatigue and to generate an overload of bloated data through which clinical staff must wade. However, the authors also offer specific ways that electronic record systems could be improved, such as compiling captured data into single graphs to enable both patients and providers to visualize what the raw information represents in a more meaningful way.

They also emphasize that technology to track, synthesize and visualize information in a way that makes sense to users is widely in use, but for some reason hasn't been integrated into EHRs.

"There is building resentment against the shackles of the present EHR; every additional click inflicts a nick on physicians' morale," the authors conclude. "Current records miss opportunities to harness available data and predictive analytics to individualize treatment. Meanwhile, sophisticated advances in technology are going untapped. Better medical record systems are needed that are dissociated from billing, [are] intuitive and helpful and allow physicians to be fully present with their patients."

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