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Both office-based and hospital-based physicians have complaints about electronic health records (EHR) and how use of the technology changes their relationship to patients. However, precisely what bothers them most differs a bit.
A study published in the Journal of Innovation in Health Informatics points out that office-based physicians were most concerned that EHRs adversely affect the quality of their interactions with patients.
Brown University and Healthcentric Advisors researchers surveyed physicians and collected responses, such as one from an office-based physician who said that taking his computer into the exam room seemed rude to him, adding, "[It's] like having someone at the dinner table texting rather than paying attention."
Meanwhile, the greatest concern for hospital-based physicians was that EHRs steal time from patient contact.
The analysis was based on open-ended answers from 744 doctors who responded to a question on the Rhode Island Health Information Technology Survey in 2014. They were asked, "How does using an EHR affect your interaction with patients?"
Background information in the study notes that federal "Meaningful Use" standards have vastly expanded the amount of information that doctors must compile, but also have become a major cause of burnout for physicians, who spend extra hours on their computers while also feeling their patient interactions have been depersonalized.
"Physicians who are burnt out provide lower-quality care," said study co-author Rebekah Gardner, MD, an associate professor of medicine at the Warren Alpert Medical School and a senior medical scientist with Healthcentric Advisors. "What this speaks to is that we, as physicians, need to demand a rethinking of how quality is measured and if we're really getting the quality we hoped when we put in EHRs. There are unintended consequences of measuring quality as it's currently being done."
Lead author Kimberly Pelland, MPH, of Healthcentric Advisors added that physicians report trying to minimize disruption from EHRs during office hours by, quoting one response, putting in "hours and hours of work at home."
On the other hand, respondents had praise for some aspects of EHRs. Some of the office-based physicians described how they pulled up and displayed educational illustrations of medical conditions when consulting with patients.
Still, most of the comments about EHRs and patient interactions were negative, study authors report.
"Those tasks require a lot more brain power, focus, and energy being shifted away from the patient," Pelland said. "The attention is being paid to the computer."