Thursday, June 30, 2016

Electronic Health Record Software Fatigue
Physicians are sick and tired of electronic health records(EHRs).
Supposedly, doctors are told, EHRs will.

·         Reduce medical records.
·         Narrow disparities in care delivery 

·         Engage patients in their own care.

·         Spark coordination of care.

·         Give access to best practice management.

·         Enhance communication across the health care spectrum.

Instead, doctors complain, EHRs;

·         Aren’t ready for prime time. 

·         Slow productivity.

·         Decrease revenues.

·         Show no return on investment. 

·         Don’t communicate with other EHRs.

·         Distract with time spend with patients. 

·         Are limited as communication tools.

·         And are, many other ways, including expense of  hiring and training staff to enter data and to code, a PITA (Pain in the Ass).

 Another Complaint

Now doctors have another complaint -  the number of alerts, alarms, and reminders popping up on EHR screens are overwhelming and are resulting  in a bad case of  “alert fatigue.
According to  a June 15 story in Kaiser Health News “Screen Flashes and Pop-Up Reminders: Alert Fatigue Spreads Though Medicine.”
“When  physicians are  hit with too much information, the result can be a health hazard. The electronic patient records that the federal government has been pushing — in an effort to coordinate health care and reduce mistakes — come with a host of bells and whistles that may be doing the opposite in some cases.”
“Electronic health records increasingly include automated alert systems pegged to patients’ health information. One alert might signal that a drug being prescribed could interact badly with other medications. Another might advise the pharmacist about a patient’s drug allergy. But they could also simply note each time that a patient is prescribed painkillers — useful to detect addiction but irrelevant if, say, someone had a major surgery and is expected to need such meds. Or they may highlight a potential health consequence relevant to an elderly woman, although the patient at hand is a 20-something man.”
“The number of these pop-up messages has become unmanageable, doctors and IT experts say, reflecting what many experts call excessive caution, and now they are overwhelming practitioners.”
“ ‘Clinicians ignore safety notifications between 49 percent and 96 percent of the time,’said Shobha Phansalkar, an assistant professor of medicine at Harvard Medical School.’When providers are bombarded with warnings, they will predictably miss important things,’ said David Bates, senior vice president at Brigham and Women’s Hospital in Bosto
In any event physicians are responding to deluge of medical alerts and alarms by simply  ignoring and overriding them most of the time.   
As the old Aesop story went,  when the shepherd boy called “Wolf! Wolf!” too many times, when the wolf finally came, no one would pay any attention to his calls for help.


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