An Internist’s Perspective: The Seven Major EHR Stressors

Ever wondered what stresses Internists the most, every single day? It's none other than the EHRs. This technology, meant to streamline healthcare, often stands between the Internist and the patient. It reduces face-to-face interaction and brings in a load of clerical responsibilities, from billing and coding to prescribing medicine electronically. A study titled "Association of Electronic Health Record Design and Use Factors With Clinician Stress and Burnout" by Philip J. Kroth, MD, MS, an eminent Internist, and his team identified an association between seven key elements in EHRs and physicians’ wellbeing. Let’s explore his findings in this blog post.

The 7 Majors EHR Stressors

EHRs are meant to make physician’s life easier, but they are commonly identified as a top contributing factor to stress. Let’s see what the 7 major EHR stressors are.

Information overload: Physicians, including Internists have too much data to handle during patient visits.

Excessive data entry requirements: Physicians spend significant time inputting data into EHRs, detracting from direct patient care.

Slow system response times: EHR systems often work slowly, causing delays in accessing critical patient information.

Inability to navigate the system quickly: Complex EHR interfaces make it difficult for physicians to locate patient information quickly, impacting clinical efficiency.

Note bloat: EHR documentation often becomes overly detailed or redundant, making it hard to find relevant patient details.

Fear of overlooking critical information: Physicians worry about missing critical information within extensive patient records, which could affect their decisions and patient care.

Notes focused on billing aspects, not patient care: EHR documentation often prioritizes billing requirements than capturing important details about patient care.

EHR-induced stress adds to a physician’s overall stress levels and can ultimately pave the way for burnout. Dr. Philip J. Kroth, the study's lead author says that burnout is a complex issue and physicians choose to retire early or go part-time due to excessive time spent on computers and not enough time for patients.

EHR Stressors And Role Of Scribes

Physicians, including internists often devote two hours to EHR tasks for every hour they spend in face-to-face consultations with patients. Dr. Philip J. Kroth noted that much of the data entered into EHRs is for purposes beyond direct patient care, such as quality control and billing. He suggests redesigning workflows to reduce EHR burdens or streamlining the process to make it less burdensome. He further recommends that scribes or medical assistants can be helpful in reducing EHR workload, a significant contributor to physicians’ stress and burnout. Another study by Dr. Philip J. Kroth focused on identifying the aspects of EHRs most associated with physician burnout and determining effective coping strategies. Here he suggested making organizational changes like providing better training on EHRs, improving the usability of HICT, and employing scribes.

Conclusion

EHRs, while intended to simplify and improve healthcare delivery, often end up creating significant stress for physicians, including Internists. Addressing these 7 major EHR stressors can reduce physician burnout and improve healthcare efficiency. Dr. Philip J Kroth, Internist recommends that implementing changes such as redesigning EHR workflows, enhancing system usability, and integrating medical scribes can significantly alleviate the burden on physicians.

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