Last week, while walking through the hospital corridors, I overheard 2 patients conversing. One of them said that doctors only care about their computers and not patients. I held my tongue lest I seem to be eavesdropping. But, nothing could be further than the truth.
Most doctors loathe the work they do in their EHRs. Most of us were not given an option in adopting this technology. The HITECH Act signed into law on February 7, 2009 gave birth to the Meaningful Use (MU) Program. While this was initiated as a bonus program for doctors implementing EHRs into their practices, it evolved into a penalizing system for those who do not comply with all its requirements. Doctors who do not participate in the MU program are currently docked in reimbursements from CMS. This penalty will grow over the coming years and become a substantial penalty for many.
Having records in digital format that are easily accessible is a fine goal. However, EHRs were not devised to fit in easily into a doctor’s work flow. They disrupt time being spent to discuss the patient. I hear many patients complains that doctors spend too much time looking at their computers. This is not because we enjoy doing this. We need to document encounters in these EHR systems or face financial penalties on work we are doing.
Not only is the software time consumptive because of inadequate technology, the MU mandates worsen this. We are required to report a whole series of metrics that prove to the government that we are using our systems in a meaningful way. This is the aspect that consumes the most time. The metrics are onerous and often things that are not necessary for the medical care of our patients. One such example is reporting our patients’ ethnicities. Some of them are of mixed backgrounds and do not fit into any of the categories. Some patients get offended when you ask what race they consider themselves. For me, race is rarely a consideration except in certain diseases. A 24-year-old college student coming in for a cold should not have to tell us the language he speaks when it is obviously English. Yet, this metric needs to be recorded in his chart for it to count.
Patients are growing frustrated by the computers snatching away their face time with their doctors. Many of them lay the blame on the doctors but this does not help the situation. Doctors are equally frustrated from being forced to use technology that does not meld well with our practice of medicine and the metric reporting requirements for MU are onerous.
Recently, doctors are voicing their concerns regarding this. However, few improvements have been implemented. EHR companies seek to maximize their bottom line, not doctor’s comfort or efficiency. Similarly, the government seeks access to patient data, as they are getting through the MU reports. Neither of these improve patient outcomes nor satisfaction. These players have become embedded in the very fabric of the healthcare system. MU and forced EHR use is eroding the very sacred doctor-patient relationship. Doctors possess little klout to overcome these mandates.
Patients need to take a more active role and understand from where the problem stems. Likewise, their voices should be heard about what this is doing to them. Only when doctors and patients stand side by side to repair this system can any real change ensue.
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