Becker's Hospital Review

44 HEALTH IT 20 Quotes That Show Just How Fed Up Physicians are With EHRs By Max Green M ore than half of the physicians who bill Medicare in the U.S. are currently penalized 1 percent of their 2015 payments as a result of the meaningful use program, according to Steven J. Stack, MD, president of the American Medical Association. "Imagine, in a world where a 2-year-old can operate an iP- hone, you have graduate-educated physicians brought to their knees by electronic health records," Dr. Stack told WBUR in Bos- ton. "When you have more than a quarter million physicians be- ing penalized by the government, by a single program, I think that most people will understand the math. It's not the 250,000-plus physicians that are the problem, it's most likely the single program they're being punished by." ough Dr. Stack may be the most vocal physician airing his grievances about EHR functionality and performance in the clin- ical care setting, he is far from the only one with gripes. One component of the AMA's Break the Red Tape town hall events, which aim to foster an open discussion of physician cri- tiques on EHR technology, is the equivalent of an open-mic slam for clinicians, featuring a revolving door of medical professionals stepping up to share their frustrations and horror stories. Here are 25 quotes illustrating just how much physicians can hate their EHR. Unless otherwise noted, all statements were either given at the AMA's Break the Red Tape Town Hall event or subsequently submit- ted to the Break the Red Tape website. Some statements have been lightly edited for style and clarity. 1. John Rogers, MD. Fairview Park Hospital (Dublin, Ga.). "Too oen I pull up a record, either in peer review or an- other setting, and it's almost impossible to really get an under- standing of the story line. On a daily basis I can't find the informa- tion, particularly nurses' notes and things like that that are really valuable to me. In a sense it's turned us into data entry clerks. Communication with patients is not only suffering, but commu- nication with nursing and others, as well. It breaks down, we all communicate now just by what goes into that electronic record." 2. Kay Kirkpatrick, MD. Resurgens Orthopedics (Atlan- ta). "We can communicate easily within our 21 locations, that's not the problem. e problem is we operate at 20 different hospi- tals in the city, all of which have their own systems. I even go to two hospitals that have the same systems set up completely differ- ently, and it's a totally different experience at the two places. Most of our consultants or people we communicate with have their own EMR systems, and unfortunately the way we get their reports is they fax them. We then print them and scan them, so they're not searchable. ey're not electronic in any way, any stretch of the imagination. It's hard to retrieve information." 3. Albert Johary, MD. Emory Healthcare (Atlanta). "e patients definitely sense that we're a lot more stressed now. We're spending three hours more per day — and that's no exaggeration — just trying to get caught up. I do mine real-time, I do my chart- ing when I'm in the room with the patient, but still that leaves no time to answer the phone calls, to answer the people that have called in, or sign off on the labs, etc. So I'm leaving at 7:30, 8 p.m. every single day. at's not sustainable." 4. Gary Botstein, MD. Dekalb Medical (Decatur, Ga.). "It's very easy to record large amounts of data and click-off boxes. So the emphasis is really on data collection, but what physicians ought to be doing is data synthesis. ey ought to be taking that data, putting it together and coming up with a differential diag- nosis and then figuring out what the best diagnosis is and then the best treatment. at has been lost in just five short years of using these products. When electronic medical record notes are generated, in the last five years I haven't seen a single differential diagnosis. I haven't seen hardly any rationale for why somebody thinks somebody has something. e only thing that goes in the impression slot is an ICD-9 code and a diagnosis name. Totally anathema to how medicine ought to be practiced." 5. Gary Botstein, MD. "In my program I have to collect large amounts of data. For example, I would see a very complex lupus patient and I counted up in my charts that it took me 48 data points to see this patient. ... When the certified EMR was in front of me, I had 280 data points...to complete. To do this voluminous review of systems that was irrelevant to my patients' visits, it was like looking for a needle in a haystack. Once all this data was col- lected you couldn't even find it." 6. V.K. Puppula, MD. Alliance Spine and Pain Centers (Atlanta). "As an attending physician, I really think that we need to drive home the message to the public that this is an impedi- ment of access to safe, quality patient care...Most systems today are not [designed around clinical care]. ey are set to comply with the federal regulations and with policymakers as opposed to actual physician-patient care, and the concern is we're basically being turned into data miners in order to spend all of our time and effort on documentation as opposed to the key issue of med- ical decision-making."

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