Doctors Give Electronic Health Records an 'F'

The transition to electronic health records (EHRs) was supposed to improve the quality and efficiency of healthcare for doctors and patients alike - but these technologies get an "F" rating for usability from health care professionals, and may be contributing to high rates of professional burnout, according to a new Yale-led study.

By contrast, Google's search engine earned an "A" and ATMs a "B" in similar but separate studies. Like EHRs, the spreadsheet software Excel got an "F."

"A Google search is easy," said lead author Edward R. Melnick, assistant professor of emergency medicine and director of the Clinical Informatics Fellowship at Yale. "There's not a lot of learning or memorization; it's not very error-prone. Excel, on the other hand, is a super-powerful platform, but you really have to study how to use it. EHRs mimic that."

Published in the journal Mayo Clinic Proceedings, the new study was a joint effort of researchers at Stanford, Mayo and the American Medical Association (AMA).

There are various EHR systems that hospitals and other medical clinics use to digitally manage patient information. These systems replace hard-copy files, storing clinical data, such as medications, medical history, lab and radiology reports and physician notes. They were developed to improve patient care by making health information easy for healthcare providers to access and share, reducing medical error.

But the rapid rollout of EHRs following the Health Information Technology for Economic and Clinical Health Act of 2009, which pumped $27 billion of federal incentives into the adoption of EHRs in the U.S., forced doctors to adapt quickly to often complex systems, leading to increasing frustration.

The study notes that physicians spend one to two hours on EHRs and other deskwork for every hour spent with patients, and an additional one to two hours daily of personal time on EHR-related activities.

"As recently as 10 years ago, physicians were still scribbling notes," Melnick said. "Now, there's a ton of structured data entry, which means that physicians have to check a lot of boxes. Often this structured data does very little to improve care; instead, it's used for billing. And looking for communication from another doctor or a specific test result in a patient's chart can be like trying to find a needle in a haystack. The boxes may have been checked, but the patient's story and information have been lost in the process."

Melnick's study zeroed in on the effect of EHRs in physician burnout.

The AMA, along with researchers at Mayo and Stanford, surveys over 5,000 physicians every three years on topics related to burnout. Most recently, the burnout rate was found to be 43.9% -- a drop from the 54.4% of 2014, but still worryingly high, researchers said. The same survey found that burnout for the general U.S. population was 28.6%.

One quarter of the respondents were also asked to rate their EHR's usability by applying a measure, System Usability Scale (SUS), that has been used in over 1,300 other usability studies in various industries.

Users in other studies ranked Google's search engine an "A." Microwave ovens, ATMs and Amazon got "Bs." Microsoft Word, DVRs and GPSes got "Cs." Microsoft Excel, with its steep learning curve, got an "F."

In Melnick's study, EHRs came in last, with a score of 45 - an even lower "F" score than Excel's 57.

And EHR usability ratings correlated highly with burnout - the lower physicians rated their EHR, the higher the likelihood that they also reported symptoms of burnout.

The study found that certain physician specialties rated their EHRs especially poorly - among them, dermatology, orthopedic surgery, and general surgery.

Conversely, specialties with the highest SUS scores included anesthesiology, general pediatrics, and pediatric subspecialties.

Demographic factors like age and location mattered, too. Older physicians found EHRs less usable, and doctors working in veterans' hospitals rated their EHR higher than physicians in private practice or in academic medical centers.

By benchmarking physicians' feelings about EHRs, Melnick said, it will be possible to track the impact of technology improvements on usability and burnout.

"We're trying to improve and standardize EHRs," Melnick said. "The goal is that with future work, we won't have to ask doctors how they feel about the EHR or even how burned out they are, but that we can see how doctors are interfacing with the EHR and, when it improves, we can see that improvement."

Edward R Melnick, Liselotte N Dyrbye, Christine A Sinsky, Mickey Trockel, Colin P West, Laurence Nedelec, Michael A Tutty, Tait Shanafelt.
The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians.
Mayo Clinic Proceedings, November 14, 2019. doi: 10.1016/j.mayocp.2019.09.024.

Most Popular Now

Open Call SC1-DTH-12-2020: Use of Real-W…

The number of people with chronic illness is growing and almost half of them have multiple chronic conditions. Patients with complex chronic conditions (CCCs) have chronic multi-morbidities or chronic disease...

China to Take on Leading Role in Medical…

Asia, in particular China, has been advancing significantly on its way to a key role in geopolitics, says correspondent Frank Sieren - and towards spearheading developments in medical technologies. At...

Doctors Give Electronic Health Records a…

The transition to electronic health records (EHRs) was supposed to improve the quality and efficiency of healthcare for doctors and patients alike - but these technologies get an "F" rating...

Artificial Intelligence Algorithm can Le…

Artificial Intelligence can be used to predict molecular wave functions and the electronic properties of molecules. This innovative AI method developed by a team of researchers at the University of...

Preventive Health Care Via App

Demand for apps for preventive health care is growing all the time. Particularly popular are diagnostic assistants that record physiological and fitness data. However, there are data protection concerns with...

Bittium Exhibits its Innovative High-Tec…

Bittium exhibits its innovative products and solutions for cardiology and neurology at Medica 2019, the leading international trade fair for the medical sector, on November 18 - 21 in Dusseldorf...

Artificial Intelligence-Based Algorithm …

Traumatic brain injury (TBI) is a significant global cause of mortality and morbidity with an increasing incidence, especially in low-and-middle income countries. The most severe TBIs are treated in intensive...

MEDICA 2019 + COMPAMED 2019 Due to Launc…

18 - 21 November 2019, Düsseldorf, Germany. From Monday until Thursday, the entire medical world and health care sector will once again meet in Düsseldorf. With a record participation of a...

A Mobile App for Managing Mobile Medical…

Beginning of March 2019, Merci Charity Boutique association based in Bucharest, Romania started testing the "Mobile app for mobile medical units and cabinets", which helps the mobile dental practice to...

#FH2019 - The Leading International Conf…

13 - 15 November 2019, Berlin, Germany. This year the German capital will host again the main conference dedicated to Digital Health: Frontiers Health 2019, which will be held from the...

MEDICA and COMPAMED Hold their Own in a …

18 - 21 November 2019, Düsseldorf, Germany. The demand market for medical technology and medical products is becoming increasingly challenging and discriminating worldwide. Providers are adapting to this on a flexible...

GE Healthcare Expands Intelligent Health…

GE Healthcare launched the Edison Developer Program to accelerate the adoption and impact of intelligent applications and developer services across health systems. The program is based on Edison, GE Healthcare's...