Slightly more physicians said that electronic health record (EHR) systems have decreased quality of care (44 percent) in their primary workplace than increased it (40 percent), according to a recent poll from Medscape.
The survey included 273 respondents—207 physicians and 66 nurses/APRN (advanced practice registered nurses)—and did find that nurses and APRNs, unlike their physician colleagues, saw more benefit than detriment in EHRs. Forty-two percent said they had increased quality of care versus 35 percent who said they had decreased care quality.
When asked what aspects of EHRs increased quality of care, the top answer among physicians was the ability to locate and review patient information more easily (59 percent), followed by the ability to electronically subscribe (49 percent), and portability/access to patient records by all members of the care team (44 percent). The same three aspects were ranked by nurses/APRNs as the top reasons EHRs have increased care quality, just in different order.
And when physicians and nurses/APRNs were asked what aspects of EHRs decrease quality of care, they gave similar weight to these four reasons: added paperwork/charting; entering data during the patient encounter; lack of interoperability with other systems; and system failures or problems.
When asked how they would like to improve these systems, physicians' top answer was to make the systems more intuitive/user-friendly (44 percent), followed by allowing greater interoperability and record sharing (30 percent). Nurses/APRNs said they would most like to see more interoperability and better record sharing (33 percent), followed by making the systems more user-friendly (30 percent).
The poll also revealed that few physicians or nurses were involved in the decision of which EHR to use in their primary workplace. Among physicians, 66 percent had no input, 28 percent had input, and 7 percent did not use an EHR system. Far fewer nurses were part of the decision making: 80 percent had no input, 18 percent had input, and 2 percent did not use an EHR.
There has been no shortage of studies over the years that have measured physician satisfaction with EHRs and how they impact the quality of care. Most have generated mixed results. For instance, Stanford Medicine’s 2018 National Physician Poll found that about two-thirds of the more than 500 primary care physicians surveyed think EHRs have generally led to improved care (63 percent) and are at least somewhat satisfied with their current EHR systems (66 percent). These same survey respondents did also continue to report problems with these systems, however, and many (59 percent) said that EHRs need a “complete overhaul.”
