A Prescription for the Achilles Heel of Healthcare IT

What keeps doctors from sleeping at night?

Electronic Health Records (EHRs).

More specifically, the “homework” these essential-but-sometimes-inefficient systems generate is enough to cause nightmares.

In a recent study that observed physician behavior, primary care providers spent 40 percent of their patient visit time focused on their computer screens, clicking and scrolling through the patient’s EHR. For those who did manage to focus more attention on their patients, EHR-related work often overflowed beyond the clinic: “I sit down and work usually until midnight,” said an anonymous physician who participated in this research.

While EHRs bring many advantages over paper medical charts, current EHR technologies demand too much of a doctor’s time, navigating nested menus, cutting and pasting text or lab results across functions and windows, responding to an avalanche of alert warnings and searching for specific data from a sea of boilerplate language or difficult-to-use templates. There are even emerging concerns that EHR complexity might have unintended consequences by serving as a new source of medical errors. According to one study, medical errors of all kinds already are estimated to cause more than 1,000 premature deaths a day in the United States.

It doesn’t have to be this way. As we observe National Health Information Technology Week, I can’t help but imagine how EHRs could be more usable and helpful to healthcare.

The idea behind an EHR—providing digital, patient-centered records that make information instantly and securely available to authorized users—is a godsend, and has the potential to

Author: Zia Agha

Zia Agha is executive vice president of clinical research and medical informatics at the Gary and Mary West Health Institute, an independent, nonprofit research organization that works to lower healthcare costs and improve care. He's also working to develop a more comprehensive understanding of clinical informatics, including clinical information systems and population analytics. Before joining the institute, Agha was director for health services R&D at the VA San Diego Healthcare System and a professor of medicine at UC San Diego. He presently holds an appointment as a part-time faculty member at UCSD.