EHR vendors must find solutions to physicians’ usability concerns

Regarding “Vendor misconceptions hamper EHR usability” (Column, April 1): I enjoyed your article and find our current dilemma as physicians frustrating. We are mandated to use electronic health records, which in many cases often aren’t ready for prime time. The disruption of work flow and creation of complexity to accomplish simple tasks are among the most frustrating aspects.

As a pediatrician in a busy office, I am most concerned about providing high-quality, personalized care in a timely fashion and documenting the necessary information so anyone can use the documentation to see what was accomplished. Our EHR demands that I take an additional two to five minutes (or more) per patient to type in data and navigate through a number of screens to code, bill and update past information. All of these things interfere with patient interaction and create a time crunch that makes seeing patients difficult and rushed. The focus is on the documentation rather than the patient. Also, there are numerous steps added to the work flow that take extra time and bog down the entire process. We all see fewer patients since implementing EHRs two years ago and take more time to do it.

We are on our second EHR, because the first one was even worse than our current one. While we did do our “due diligence,” the product choices were all very similar and failed to really provide anything very different from each other. All have the same usability problems in my search.

I consider myself to be technically savvy. I toy around with programming and Web design. I run Linux and build computers. I see how computers can become a useful tool in a physician’s office, but the current products all fail to provide value for us. Vendors shun us as “silly physicians” who aren’t smart enough or flexible enough to accept change. While there are always some of those, most of us just want something that will allow us to do the work we do — see patients — without creating extra steps or effort to the process.

Because we are mandated to use EHRs, we can’t wait for the products to evolve into something useful. We have to purchase them now — something most of us never would have done at this stage. The fact that vendors are benefiting from sales takes away motivation to improve them. Changing from one EHR to another is onerous and very costly. As a result, once you buy one, you become stuck whether you like it or not.

I would love to help move the process along and make the industry come up with better solutions, but I am afraid we are trapped with garbage. If you can connect me to anyone or any group that is working to fix this problem I would be ecstatic.

— Dave Denton, MD, Pocatello, Idaho