Given how innovative and game-changing electronic health records have been for the healthcare sector, you would think more providers would be excited about using them. Some are, of course — but the reception that these information-centric innovations have received has been oddly mixed.
Electronic health records offer providers a real-time digital version of a patient’s paper chart, which encompasses not only the details of their medical and treatment histories but also a broader, high-level view of the patient’s health. Unlike traditional paper filing systems, EHR systems are designed to allow treating physicians to securely transmit care information to a patient’s other clinicians, emergency facilities, pharmacies, and pharmacies. This shareability ensures that a patient’s EHR should — in theory — always be up-to-date and provide physicians with the information they need to develop a detailed care plan.
The benefits of incorporating EHR use into practice are well-documented. In 2014, a report published by the Office of the National Coordinator for Health Information Technology noted that patient outcomes tended to improve when providers used EHRs to manage their patient’s medications, with EHR use correlating to a 52 percent drop in adverse drug events. EHRs have also been found to boost provider efficiency by reducing duplicate tests and notifying caregivers of critical lab values in a timely and clear manner.
Patients see a benefit beyond improved care outcomes, too. Unlike with paper charts, patients have direct access to their EHRs. They can read, print, and transmit their health information without needing to communicate with the last provider who updated their records.
One might think that with all of these evident benefits, providers and care organizations would be in wholehearted support for EHR technology — and, to be fair, adoption rates have come a long way. Data published by the Office of the National Coordinator for Health Information Technology reports that almost all (96 percent) of surveyed hospitals possessed a certified EHR system in 2015, an over ninefold increase from the rate reported in 2008.
Adoption is high, yes — but so is frustration. Despite the apparent potential, providers haven’t always achieved the unmitigated benefits they expected from their EHR investment. In 2018, a joint survey conducted by researchers at Stanford and Harris Poll found that: “While roughly two-thirds of PCPs think EHRs have generally led to improved care (63%) and are at least somewhat satisfied with their current EHR systems (66%), they continue to report problems.”
Four out of 10 primary care physicians believe that EHRs present more challenges than benefits, while 49 percent believe that using digital record systems detracts from clinical effectiveness. Arguably worse, 71 percent of physicians reported that EHRs “greatly contribute” to physician burnout. Given this, it’s not all surprising that six in ten physicians also believe that their EHR systems require a full overhaul.
Researchers for a 2016 Mayo Clinic study came to similar conclusions during their assessment of physician experiences with EHR systems. As lead scientist Tait Shanafelt summarized for Science Daily, “Electronic health records hold great promise for enhancing coordination of care and improving quality of care. In their current form and implementation, however, they have had a number of unintended negative consequences, including reducing efficiency, increasing clerical burden, and increasing the risk of burnout for physicians.”
This usability issue poses an enormous problem for providers, patients, and EHR system makers alike. If providers can’t realize the potential benefits that EHR systems provide, those digital platforms become frustrating, even more so than paper systems. But while many EHR frameworks undoubtedly need a user-interface overhaul, I believe that much of the problem lies in implementation.
EHR platforms aren’t a point-and-shoot solution; they won’t offer maximum benefits simply by being available. Instead, organizations need to carefully strategize their EHR implementation and commit time and resources alike to training physicians on EHR use and achieving buy-in from staff. Healthcare leaders need to invest in the right digital systems, obtain outside consults to drive their EHR strategy, and thoroughly train and support their team during the implementation period. This isn’t a one-off installation; it’s a weeks- — or even — months-long process that needs to be carefully planned and executed.
This idea holds for most innovations in the healthcare fields, and not just for EHRs. While healthcare leaders should invest in new and high-potential tools, they need to temper their enthusiasm with long-term strategy and careful planning. Otherwise, they risk failing to achieve those tools’ benefits and prompting staff disengagement.
“While cutting-edge technology and talent are certainly needed, it’s equally important to align a company’s culture, structure, and ways of working to support broad […] adoption,” McKinsey partner Brian McCarthy once wrote of AI adoption for the Harvard Business Review. “But at most businesses that aren’t born digital, traditional mindsets and ways of working run counter to those needed.”
Healthcare innovations like the EHR can improve efficiency, boost care quality, and improve experiences for patients and providers alike — but they need to be implemented thoughtfully.
