Industry Insight

Study Finds EHRs Taking a Toll on Physicians

The growth and evolution of the electronic environment in health care is taking a toll on US physicians. That’s according to a national study of physicians led by Mayo Clinic, which shows the use of EHRs and computerized physician order entry (CPOE) leads to lower physician satisfaction and higher rates of professional burnout. The findings appear in Mayo Clinic Proceedings.

“Electronic health records hold great promise for enhancing coordination of care and improving quality of care,” says Tait Shanafelt, MD, a Mayo Clinic physician and lead author of the study. “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.”

In collaboration with investigators from the American Medical Association (AMA), researchers from Mayo Clinic assembled a national sample of US physicians using the AMA Physician Masterfile, a near-complete record of all US physicians. The survey included validated instruments to assess burnout, as well as items developed specifically for the study to evaluate the electronic practice environment of the participating physicians.

The study found that physician satisfaction with clerical burden, EHRs, and CPOE varied dramatically by specialty. Family medicine physicians, urologists, otolaryngologists, and neurologists were among the specialties with the lowest satisfaction with clerical burden. Use of EHRs and CPOE were associated with lower satisfaction with clerical burden and greater risk of burnout. The researchers found that use of CPOE was the characteristic of the electronic practice environment most strongly associated with the risk of burnout.

The study used data from 6,560 physicians in active clinical practice surveyed between August and October 2014. The study included physicians from all specialties in the United States. Results were adjusted for age, sex, specialty, practice setting, and hours worked per week.

“Although electronic health records, electronic prescribing, and computerized physician order entry have been touted as ways to improve quality of care, these tools also create clerical burden, cognitive burden, frequent interruptions, and distraction—all of which can contribute to physician burnout,” Shanafelt says. “Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the US health care system is less clear.”

To mitigate these negative effects of the electronic environment on physicians, Shanafelt recommends finding ways to incorporate these tools in a manner that does not increase clerical burden for physicians or reduce their efficiency.

The researchers say further studies must be done to determine the optimal way to do so and to determine whether the observed associations are causal.

— Source: Mayo Clinic

AMDIS and OpenNotes Announce Partnership
to Empower Patients

The Association of Medical Directors of Information Systems (AMDIS) and OpenNotes have announced a partnership to advance transparency in health care and enhance patient and clinician communication by inviting patients to read and engage with the contents of their medical records.

“Our partnership with OpenNotes is an opportunity for us to support the AMDIS mission of improving health care through the use of information technology, by empowering patients with their own health information,” says William Bria, MD, chairman of the board of AMDIS.

AMDIS is committed to advancing the field of medical informatics and improving the practice of medicine. Its members are physician leaders in HIT.

“These are doctors who are extremely savvy about technology and play a leadership role in advancing the use of technology,” says Homer Chin, MD, who leads efforts to integrate HIT further with OpenNotes. “While OpenNotes isn’t a technology itself, notes are most easily shared using existing EHR platforms. This partnership allows these doctors to continue to use their knowledge to do the right thing for patients. We share the goal of getting patients, and often their families, literally ‘on the same page’ with their doctors.”

Studies consistently show that engaged patients have better outcomes.

“Our research supports those findings and suggests that OpenNotes may be a powerful way to enhance engagement,” says Jan Walker, RN, MBA, cofounder of OpenNotes and an assistant professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center (BIDMC). “Patients tell us they feel more in control of their care and are more likely to follow up on recommendations.”

New research suggests that having a second set of eyes on the record may also be an important way to improve patient safety. And record sharing using OpenNotes may play a vital role in helping care partners, from pediatrics through geriatrics, make better, more informed decisions about their loved ones’ care.

“Open Notes is fundamental to shifting the center of care from the health care system to the individual person, and while there are many components to this critical shift, the seminal role of OpenNotes is clear,” says John Mattison, MD, chief medical information officer of Kaiser Permanente in Southern California. “In our system, we now have more than 600 doctors sharing notes with more than 1.2 million patient encounters, and that number is growing exponentially. We expect all 8,000 doctors to be on OpenNotes by the end of 2017.”

— Source: OpenNotes

Verisma Appoints New President and CEO

Verisma, a provider of release of information (ROI) automation systems for the health care industry, recently announced that Marty McKenna has been appointed as its president and CEO, effective immediately.

“We are delighted to welcome McKenna to the Verisma team,” says Ken Thompson, chairman of the board of directors. “We ultimately selected McKenna for his focus on the customer and his proven ability to build talented teams. At Verisma, our mission is to offer unmatched customer service and superior solutions by building the best team in the industry. McKenna’s proven track record in the health care information and technology marketplace will continue to establish Verisma as the premier provider of ROI solutions.”

“It is a privilege to be named Verisma’s CEO and lead an organization that is revolutionizing the ROI marketplace through its innovation, technology, and services,” McKenna says. “The opportunities ahead for Verisma are limitless, and I look forward to working with the Verisma team to continue to grow the company.”

McKenna brings exceptional experience and depth of knowledge to Verisma. He has held multiple leadership roles in HIT from president of Allscripts Analytics, to leading global marketing and commercial operations for dbMotion. During his 11 years at General Electric, McKenna served as the global general manager for General Electric’s suite of perioperative IT solutions, global integration manager for multiple acquisitions, general manager for health care information services, and manager of clinical consulting.

— Source: Verisma