Physician and Electronic Environment

Electronic Environment

"The era of information technology in medical practice, most notably electronic health records (EHRs) and computerized physician order entry (CPOE), began in the 1990s, and the technologies have been slow in becoming embraced by the medical community because they are challenging and time-consuming to learn [37]. Approximately 85% of physicians currently use these technologies, and about 60% think that EHRs have improved the quality of care [37,53]. However, the technology has been slow to improve efficiency of care. Surveys have shown that approximately 43% to 75% of physicians think that EHRs decrease efficiency and 47% to 61% of physicians think that using EHRs detracts from patient interaction [37,53,59]. One study showed that physicians who used EHRs spent slightly more time on administrative tasks than physicians who used paper records (17% of work time vs. 15% of work time) [57]. In another study, emergency department physicians spent a mean of 43% of their time on data entry, a significant difference from the time they spent on direct patient care (28%) [60]. In general, physicians are dissatisfied with the amount of time they spend using electronic documentation systems, and stress levels increase and satisfaction levels decrease with increasing use of EHRs [56,61,62]. Physicians who use EHRs and CPOE are also at higher risk for burnout, and "increased computerization of practice" was the fourth most common cause of burnout in the Medscape Lifestyle Report [31,61]. As more physicians become comfortable with using electronic systems, their satisfaction may improve."

"Often, the drug interaction alerts are too sensitive. More than once, an alert has appeared warning me that if I hit the “prescribe” button, that my patient will suffer the same fate as did the Wicked Witch of the West when Dorothy doused her with water. When I can’t verify this doomsday scenario using old fashioned techniques, I call the pharmacist directly who may reassure me that the drug is safe to use. So, I prescribe the drug knowing that my EMR system will document that I have been duly warned and have chosen to cavalierly override the admonition. Guess which profession likes this EMR function?"

from kevin  MD