Inpatient Physicians find EHRs more Taxing than Outpatient Physicians, says Study

Inpatient Physicians find EHRs more TaxingEHR use has been identified as a major cause for physician burnout. A study conducted by the RAND Corporation and the American Medical Association (AMA) identified EHRs as the main reason for physician dissatisfaction, emotional fatigue, depersonalization, and loss of job satisfaction. Many studies also show how data entry in EHRs affects patient-physician interactions in outpatient settings, a situation which medical transcription outsourcing helps address to a great extent. Nevertheless, a recent article in AMA Wire discussed a study in the Journal of Innovation in Health Informatics which found that EHRs pose even more challenges for inpatient interactions. Hospital-based physicians find EHRs more taxing to manage than office-based physicians, says the study.

The researchers’ findings were based on a qualitative analysis of a statewide physician survey across specialties to evaluate hospital-based physicians’ perceptions about how using an EHR impacts their interactions with patients. This new EHR survey covered more than 700 hospital and office-based physicians who were asked the question, “How does using an EHR affect your interaction with patients?”

The study found that EHRs pose a “different kind of drain” for hospital physicians. A lead researcher pointed out that this is because the relationship and conversations that an inpatient physician has with patients is very different than the outpatient physician. The focus was on five main themes for hospital-based physicians and their perception of EHRs. Though the themes were similar for outpatient and inpatient providers, the ranking order was different for hospital physicians, stating that EHRs:

  • Mean less time to spend with patients because more time is required for documentation.
  • Reduce the quality of the patient-physician interaction and relationship.
  • Have no effect on patient interaction.
  • Improve access to information, which benefits patient interactions.
  • Were negative or positive, but non-specific comments about patient interactions.

The key issue for inpatient physicians was the burden of EHR documentation requirements. Spending more time on computer data entry affected patient contact, which increased their frustrations and often led to burnout. Here are the comments made by two hospital-based respondents:

“My nose is now burrowed deep into my computer interface, leaving markedly reduced time to make eye contact and actually interact one on one with my patient.”

“I don’t feel connected as I am always looking at the screen typing. The art of medicine and treating is lost in the process.”

While the office-based physicians highlighted how lack of quality time affected their relationship with patients, the hospital-based physicians were critical about the impact of reduced time for interactions.

Inpatient Physicians find EHRs more TaxingHow can the situation be improved? Inpatient and outpatient settings need strategies, according to the research. Hospital-based physicians stressed the use of problem lists and lab results to be better prepared for the clinical encounter. For the inpatient setting, the researchers recommend improving the user interface and usability of the EHR itself to make it a much more intuitive flow. This will allow hospital physicians to use the EHR more quickly and get more time with patients.

On the other hand, office-based physicians put forward solutions like facing the computer screen toward the patient and including them in the process using scribes.

Another recent study also reported similar results. The Society of Hospital Medicine (SHM) released a report titled “Hospitalist Perspectives on Electronic Medical Records at HM17 which stated that “a staggering” 85% of providers said they spend more time interacting with their inpatient EMR than their actual inpatients.

A key takeaway finding from these studies is that both practice-based physicians and inpatient physicians can benefit from support for EHR clinical documentation. Medical transcription companies provide this support with EHR-integrated documentation solutions. They provide a wide variety of reports in electronic format including history and physical, physician notes, lab results, SOAP notes, radiology reports, medication lists, and discharge summaries. By importing these into EHRs, expert medical transcriptionists provide complete documentation in hospital and outpatient settings. Opting for medical transcription services can reduce physician burnout due to tasks involving EHRs, improve the day-to-day workings of EHRs, and enhance patient and provider interactions for greater satisfaction and outcomes.