Issue link: https://beckershealthcare.uberflip.com/i/1122871
64 PATIENT EXPERIENCE 1st-year physicians spend more time interacting with EHRs than patients By Andrea Park F irst-year physicians spend, on average, 43 percent of the day interacting with patients' EHRs, according to a study published in JAMA Internal Medicine. After observing interns in internal medicine departments for a total of 2,173 hours over more than two months, re- searchers found that first-year physicians spend 66 percent of their working time in indirect patient care, including nearly half of the day interacting with EHRs. Furthermore, while the observed interns spent an aver- age of just 13 percent of their time in direct patient care, that time was often spent multitasking. While interacting with patients, the first-year physicians regularly engaged in indirect patient care activities like working with EHRs, viewing images and reports, and communicating with team members. The study authors suggest that time spent in direct patient care is declining due to "the diffusion of the electronic health record, demands for more detailed documentation, and pressures to decrease the length of stay for common clinical conditions." n Physician viewpoint: Lack of EHR sharing prevents patient care By Jackie Drees P atients suffer treatment delays and are sometimes forced to undergo medical tests they have already completed when they switch providers, infectious diseases specialist Pranay Sinha, MD, wrote in WBUR. While physicians may feel irritated at the lack of EHR interoperability between healthcare organizations, pa- tients experience pain and delays in their diagnosis and treatment when physicians must wait for copies of their medical records, Dr. Sinha, an infectious diseases fellow at Boston University School of Medicine, wrote. Dr. Sinha, who works at a tertiary center, said patients are often transferred to his medical center when surround- ing hospitals lack necessary services. When patients are transferred, medical records sent with them are often incomplete or tests that the patient has undergone are still pending results. These circumstances leave physicians having to track down updates from the patient's previous hospital to move forward with their treatment plan. "Countless patients suffer the steely stabs of our needles as we repeat tests that they received just hours ago in dif- ferent facilities," Dr. Sinha wrote. "Claustrophobic patients brave the disconcerting confines of our CAT scan and MRI machines because their previous images languish in the records of other hospitals." Fragmented health records can also increase costs as patients are left to pay for medical tests they have already undergone, but lack record of, Dr. Sinha wrote. While some states have introduced health information exchang- es to improve health record sharing between unaffiliated hospitals and health organizations, they are not nearly as widespread as they should be, according to the report. Massachusetts implemented its HIE, MassHiway, in 2012, yet no residents or medical staff from four large Bos- ton-based medical training programs were familiar with the technology when Dr. Sinha asked them, he wrote. "It's like inventing penicillin and forgetting to inform [phy- sicians]," Dr. Sinha wrote. n Costly, aggressive treatments often used on end-stage cancer patients By Mackenzie Bean M any patients with late-stage cancers pursue aggressive treatment options instead of end-of- life care, according to a study published in JNCI Cancer Spectrum. For the study, researchers examined clinical data on 100,848 metastatic lung, colorectal, breast and pancreat- ic cancer patients from the National Cancer Data Base. Patients all died within one month of being diagnosed between 2004 and 2014. They found treatments varied based on cancer type, age, insurance and type of healthcare facility. However, many patients still sought aggressive treatments despite the ad- vanced stage of their cancers. About 28 percent of colorec- tal cancer patients underwent surgery, and 18.7 percent of lung cancer patients had radiation. The researchers concluded more research is needed to bet- ter identify cancer patients who will not benefit from these types of aggressive and expensive treatments. n