EHR Innovations for Healthier Patients and Happier Doctors
EHR Innovations for Healthier Patients and Happier Doctors
This special issue explores a range of health information technology (HIT) issues that can help primary care practices and patients. Findings address the design of HIT systems, primarily electronic health records (EHRs), the utility of various functionalities, and implementation strategies that ensure the greatest value. The articles also remind us that, while HIT can support the delivery of care, it is not a panacea. To be effective, functionality needs to be relevant and timely for both the clinician and patient. Prompts and better documentation can improve care, and "prompt fatigue" is not inevitable. Information presented within EHRs needs to be actionable. There is an ongoing tension between information overload and the right—and helpful—information. Even the order of presentation of information can make a difference in the outcome. Whether supported by HIT or not, basic tenants of care, such as including the whole care team in trainings, communicating with other providers, and engaging patients, remain essential. The studies in this issue will prove useful for informatics developers, practices and health systems making HIT decisions, and care teams refining HIT to support the needs of their patients.
If your practice is like mine, you cannot walk down the hall without hearing someone complain about your electronic health record (EHR). Why is the system so slow today? Why can't the EHR help me with … [insert some important patient care task]? Why does the EHR always make me … [insert some annoying meaningful use requirement]? Why does it take so long to … [insert something you do dozens of times each day]?
These complaints are not surprising. An EHR is literally right in front of most clinicians' face for over 8 hours every day. Clinicians' lives revolve around their EHR. A clinician commonly accesses, views, and enters information in the EHR throughout a patient encounter. Minutes between patient time and even personal time is spent completing tasks and messaging patients through the EHR. Despite its prominence in our life, EHRs, and health information technology (HIT) more broadly, are still in their infancy. We only started incenting practices and hospitals to adopt EHRs in 2009. Not until 2016 will meaningful use focus on improved outcomes. At best, clinicians are ambivalent as to whether they are satisfied with their EHR and whether they think it helps patients. In fact, clinician dissatisfaction and burnout is at an all-time high, in part directly because of the burdens imposed by EHRs.
Yet, if your practice is like mine, you would never go back to paper records. EHRs can better organize information, remind us about what we need to do, coordinate and track activities over time and across team members, and support communication with patients and specialists. Much of what family physicians do centers on information: to make good decisions, to coordinate care, and to empower patients with information. And there is hope for the future—EHRs can get better. The secretary of Health and Human Services has gone so far as to pledge to make clinicians happier by making their EHR better.
Abstract and Introduction
Abstract
This special issue explores a range of health information technology (HIT) issues that can help primary care practices and patients. Findings address the design of HIT systems, primarily electronic health records (EHRs), the utility of various functionalities, and implementation strategies that ensure the greatest value. The articles also remind us that, while HIT can support the delivery of care, it is not a panacea. To be effective, functionality needs to be relevant and timely for both the clinician and patient. Prompts and better documentation can improve care, and "prompt fatigue" is not inevitable. Information presented within EHRs needs to be actionable. There is an ongoing tension between information overload and the right—and helpful—information. Even the order of presentation of information can make a difference in the outcome. Whether supported by HIT or not, basic tenants of care, such as including the whole care team in trainings, communicating with other providers, and engaging patients, remain essential. The studies in this issue will prove useful for informatics developers, practices and health systems making HIT decisions, and care teams refining HIT to support the needs of their patients.
Introduction
If your practice is like mine, you cannot walk down the hall without hearing someone complain about your electronic health record (EHR). Why is the system so slow today? Why can't the EHR help me with … [insert some important patient care task]? Why does the EHR always make me … [insert some annoying meaningful use requirement]? Why does it take so long to … [insert something you do dozens of times each day]?
These complaints are not surprising. An EHR is literally right in front of most clinicians' face for over 8 hours every day. Clinicians' lives revolve around their EHR. A clinician commonly accesses, views, and enters information in the EHR throughout a patient encounter. Minutes between patient time and even personal time is spent completing tasks and messaging patients through the EHR. Despite its prominence in our life, EHRs, and health information technology (HIT) more broadly, are still in their infancy. We only started incenting practices and hospitals to adopt EHRs in 2009. Not until 2016 will meaningful use focus on improved outcomes. At best, clinicians are ambivalent as to whether they are satisfied with their EHR and whether they think it helps patients. In fact, clinician dissatisfaction and burnout is at an all-time high, in part directly because of the burdens imposed by EHRs.
Yet, if your practice is like mine, you would never go back to paper records. EHRs can better organize information, remind us about what we need to do, coordinate and track activities over time and across team members, and support communication with patients and specialists. Much of what family physicians do centers on information: to make good decisions, to coordinate care, and to empower patients with information. And there is hope for the future—EHRs can get better. The secretary of Health and Human Services has gone so far as to pledge to make clinicians happier by making their EHR better.
