Why Do Doctors Dislike Electronic Health Records?

Category: Health

Do you ever get the sinking feeling your doctor is so busy typing notes into a laptop, he or she doesn't hear what you are trying to say about your symptoms? No, it’s not just you who thinks so; according to a survey of physicians who use electronic health records (EHR) systems every day, all of that mandatory note-taking is interfering with patient care, and causing doctor burnout. Read on to learn what doctors say is wrong with the computerization of healthcare, and how they want it to be fixed...

Do Electronic Health Records REDUCE Patient Care?

Stanford Medicine, the umbrella name for the prestigious California medical school and its associated hospitals, conducted a poll of 521 primary care physicians (PCPs) with the aid of The Harris Poll. The survey of doctors' perceptions of Electronic Health Records (EHR) systems focused on problems that PCPs encounter with EHRs, and there are some pretty big ones.

Doctors are not exactly enthralled with EHR systems. Only 66% are even “somewhat satisfied” with the EHR systems they use. Put another way, 40% of PCPs say electronic health records are more trouble than they are worth. For every hour of patient contact, doctors spend almost 2 hours entering data in EHR systems. It’s not to see why when we look at how much of a PCP’s time is chewed up by EHRs.

Another study from the American Journal of Medicine shows the correlation between EHR and doctor burnout, which in turn results in medical errors, lower quality of care, higher costs, and overall worse outcomes. Doctor burnout is bad not only for the patients, who see the physician as irritable or impatient, but it also contributes to depression, substance abuse, and alarming rates rates of suicide among doctors.

Why Doctors dislike Electronic Healthcare Records

An astounding 62% of “patient time” is spent in the EHR system, the docs reported. Assuming an office visit is scheduled to last 15 minutes, that means your doctor has only 5 minutes, 42 seconds to spend talking with you, and those seconds are reduced by the obligatory “Take deep breaths… now breathe normally… say ‘Ahhh...’” routine. So the next time your doctor is running late, remember that he may be trying to actually practice medicine as well as type.

Many PCPs have little discretion about how much time they can spend examining and talking with patients instead of feeding data to “the system.” Large healthcare corporations own many primary care practices, and those corporations require data for a variety of reasons. The data is required by insurers to be used in setting reimbursement rates. The government incentivizes data collection through Medicare and Medicaid programs that tie physician pay, in part, to proper documentation of a patient’s diagnosis, treatment, and health outcome.

Seventy-one percent of PCPs surveyed agree that EHRs “greatly contribute to burnout.” Fifty-nine percent agree that EHR systems they use “need a complete overhaul.” This is no surprise because EHR systems tend to be designed by computer programmers who do not have to work with patients.

Benefits of Electronic Healthcare Records?

The primary benefit that 44% of PCPs see in EHR systems is “data storage,” not better patient health outcomes. Your doctor, too, feels like just a cog in a machine.

Efforts are being made to address mental health concerns of doctors, which result in poorer patient care. Seventy-two percent of PCPs feel that improving the user interface is the most important thing that EHR system designers should be pursuing right now. Sixty-seven percent believe that interoperability deficiencies are the most important thing to address during the coming decade. If that means I won’t have to repeatedly write the same info on “new patient intake” paper forms over and over, then I am all for interoperability! But we have a long way to go before we get there.

Recently, a friend got some X-rays taken at an imaging center whose office was nothing short of palatial. The specialist who ordered the scans had an equally well-appointed office. During intake, he was asked if he would like to be part of a program that allows physicians to access his images electronically. “Where do I sign?” he asked immediately. But on his way out, he had to wait five minutes while his images were copied to a CD, which he was told to give to his specialist on his next visit. It's occasions like that one for which the “facepalm” was invented.

Your thoughts on this topic are welcome. Post your comment or question below...

electronic health records, why doctors hate electronic health records, digital health records, computerized healthcare records

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Most recent comments on "Why Do Doctors Dislike Electronic Health Records?"

(See all 26 comments for this article.)

Posted by:

14 Aug 2020

Great topic. I don't buy their estimate of report writing to patient contact time. I've seen my doctor's notes on my visits and they seem rather simple and don't much reflect anything different from our conversation during the visit. If there is more being added to or reviewed in the records, then the appropriate course of study would be observing the doctors as they do their work, not a survey of the doctors impressions of how they do their work. Efficiency in user interface is a complaint in many systems. It's surprising to me that all businesses haven't become "cleaner" in the User Interface department. Maybe programmers just don't listen to the UI folks. ;-{)

Posted by:

Bob Kinsler
14 Aug 2020

Dragon Software for the MD, OD and others to speak into and have the words appear on the necessary forms (as I suggested to the VA some time ago).

Posted by:

Stef Wohl
14 Aug 2020

Many times the only word to describe how I feel is a Yiddish expression. Since most all the doctors I used to see spoke, or at least understood the expressions there was no problem what so ever. Doctor "Chippy" Felson who grew up in the same ghetto of Cincinnati as my father spoke Yiddish. There never was a problem. Chippy's hand was in your hand not on a keyboard and he was looking directly into you eye, not a glowing blue screen making typos. Two generations later and computers do not understand Yiddish or probably any other language. [Note: I've been around computers since the IBM 360, tape drives and when the first hard drives were around a foot and a half in diameter and very heavy.] Thanks for allowing my rant. LOL

Posted by:

14 Aug 2020

The missing piece in this is the fact that doctors have to see so many patients a day. Even without the data input, having to see a patient every 15 minutes doesn't allow for any in-depth evaluation and/or treatment. If they did not have to see so many patients, or they had someone else available to enter the information while the doctor takes care of the patients, would solve much of the problem. But that would mean cutting into the profit margins of the corporations involved. It's no wonder that concierge medicine is expanding across the country.

Posted by:

Sarah L
14 Aug 2020

When the electronic record system was installed at the offices of one doctor I saw, it ruined my visits with her. When she took her own notes on paper, she glanced at those and began talking with me with full knowledge of my situation, all brought back to her mind by her notes. The electronic system was not to her liking but she had to use it. She no longer had the memory of medicines or routines we had tried, and she was clearly frustrated. So was I.

A doctor I see now is better at putting things in online files than he is of taking care of me.

When can this situation get turned into something useful?

Posted by:

14 Aug 2020

I'm a Canadian so the system is different here. My doctor uses an EHR and I've never heard any complaints about it. The big advantage, of course, is that any doctor I go to has my health history immediately available. However, your article doesn't really say why doctors dislike them. Is it because they are badly laid out? Something else?

Posted by:

Dennis W. Waterman
14 Aug 2020

There is (or at least CAN BE) a huge win for the electronic system. Here in Wisconsin all hospital records at the major facilities at least are on Epic Software and are available across the competing hospitals.

In February my wife was taken out by a drunk driver and had a compound fracture of her ankle and a lot of blood loss as a result. The ambulance crew was fantastic and took her to the closest Level 2 Trauma Center and passed right by her hospital of choice.

The Trauma Center put in her name, SS#, etc and had INSTANT access to all her medical records from the competing hospital less than two miles away. All the medications, treatment records, the name and phone number of Primary Care Doctor etc.

When her blood pressure dropped to 40 over whatever they were able to stabilize after seeing a medication that interfered with the sedation and pain med they gave her. Six months later she is finally able to walk with a cane (slow but at least able to) but without that access to those records she would probably have died.

Every state should mandate that these records are available for such emergencies.

Posted by:

14 Aug 2020

Another Canadian here -one of my Dr.'s creates an EHR while I am in his office. Sometimes he scrolls up to view previous notes or medical records from a medical specialist. The medical specialist records cannot be accessed by Dr's at a Toronto Hospital. When I had a 2 night stay in our local hospital last year they could not access the medical history created by my PCP (including my current medications prescribed by both my PCP & medical specialist). Obviously our EHR system is still a work in progress.

I have known the rate of Dr. & dentist suicides has been above average in Canada over many years. Overall recognition of burn out is a problem that should be addressed.

Posted by:

14 Aug 2020

The professionals I see have a "scribe" in the exam room who directly enters the medical data during the visit.

My general practitioner makes house calls which are NOT limited to 15 minutes and immediately records medical data during the extended visit.

The value of consistent, readily available medical history and data does not require extra work if efficiently made part of the visit to begin with.

Posted by:

14 Aug 2020

To Jim H:

Doctors are required to correct or add an amendment to your records.

Quote (directly from HHS government website)


If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record. The health care provider or health plan must respond to your request. If it created the information, it must amend inaccurate or incomplete information.

If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.

End quote

Posted by:

14 Aug 2020

Having spent the majority of my life as an RN, one of the biggest reasons that doctors and the medical field in general don't like electronic records is HIPPA. There are too many ways that records can be hacked and then the health care professional becomes the responsible party.

Posted by:

14 Aug 2020

The line that jumped at me was “designed by computer programmers who do not have to work with patients.” This is too true of too many websites. I imagine the issue is with the software used more than the age of the doctors, though.

Posted by:

14 Aug 2020

From what I understand the ACA mandated electronic storage of health records. It did not however mandate they be in a universal format. Therefore each medical group has proprietary software so we end up with faxes,cd's and printed pages as the means of communicating between health care providers. Extremely wasteful or time and resources for both the provider and the patient. Due to Covid restrictions I recently waited 2 hours in my vehicle an appointment for my wife because the lab had not faxed the lab results to the doctor, and the lab was closed for an hour for lunch. The appointment usually takes 30 minutes.

Posted by:

Brian B
15 Aug 2020

Whenever I have needed medical attention in the past, I have always thanked my lucky stars that I didn't live in the US. This article just confirms my opinion.

Posted by:

Wild Bill
15 Aug 2020

Boy, did this topic bring out the responses. I would note that the "Say ahh..." bit is usually carried out by a Medical Assistant, thus not cutting into the 15 minute visit time of the physician. The data entry time, on the other hand, does. Hopefully, this problem becomes less so as technology advances. An AI that recorded the visit/interaction might allow for a less time-intensive experience on the part of a valuable resource, the physician.

Posted by:

15 Aug 2020

The reason that the Amazon website is so good: they hired Seattle Librarians to design it, and the computer programmers had to make it that way.
The EHR program that my doctor uses requires filling out every box on the page before it will go to the next page. They need doctors and nurses to redesign the programs they use.

Posted by:

15 Aug 2020

Thank you Bob Rankin, for all you do to keep us informed.
In my neck of the woods, the actual Doctor walks into the room w/a 'stenographer' (of sorts) in tow. Maybe my health provider provides TMI but I notice that a normal routine yearly doctor's visit is billed as 30 minutes but I am venturing to guess that my face time with the doctor (+tow) is about 5 minutes and another 10 minutes with other healthcare aids asking questions and/or probing. I don't seem to feel any pity for GP computer burnout. It's like me complaining that breathing is stressing me out just because I need oxygen uptake!
@StefWohl - What is the Yiddish expression you speak of? Is it 'hand-in-hand' or do you mean "Oy Vey"?

Posted by:

16 Aug 2020

How does EHR compare to how much time a Dr spent doing records?
Totally agree with systems designed by programmers simply are useless for any frontline workers in terms of utility. I have experienced systems in the medical field, social services field and finance field. They all have created more work for users. And no utility. And created issues and dangers. And of course never implemented with proper or any training at all. Most recent example MS 365. MS office 2010 works better!

Posted by:

17 Aug 2020

My best friend for 50+ years is a pediatrician. The notes done in the office are only a portion of what he does on their records. The rest of it comes at home, at nights, and on weekends. And this is with him having an electronic system. Electronic systems deal with what is usual or typical or frequent. Pediatricians and other doctors deal with unique individuals that do not necessarily follow the book exactly; their symptoms don't quite match, etc. The true doctoring comes in seeing what does not (often should not) go together. Electronic systems are not open to "AHA" moments where something just clicks in a good doctor's mind.

Posted by:

17 Aug 2020

Watching nurses forced to use drop down lists and scrolling to enter a temperature or blood pressure, some of the most obvious issues are exposed. Basic data entry should NEVER use a mouse! Entering 97.6 is 4 keystrokes, press [ENTER] is a 5th. If you want to skip fields, then a mouse might work better then the [TAB] or [ENTER] key. But the data entry screens programmers are creating these days SUCK! The doctors often aren't treated any better. If your condition is not in some list, they can't enter it! This is the worst of software design and I see it not just at my doctor's office, but on my banking website and shopping cart systems constantly! I've been programming full time since 1978 and the advent of the mouse might be one of the worst things to ever happen! Understand what you need to do BEFORE you create a user interface!!

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