EHR Gets an F Fom Physicians

Survey of physicians also links usability score to burnout
Robert Calandra

A new study published in the journal Mayo Clinic Proceedings, confirms what most physicians already know: The electronic health record is user-unfriendly to the point of hostile. 

The researchers asked 1,250 physicians to rate the EHR technology on a standardized 1–100 usability scale. In that group, 870 (69.6%) answered all 10 items on survey. The results averaged out to 45.9, which is in the bottom 9% of scores from previous usability studies that had, for example, given Google's search engine an A and ATMs a B.  The researchers said the 45.9 score put the doctor's ranking of the EHR  into the "not acceptable" range that is analogous to an F grade.

Of course there was some variation. For example, doctors who worked in academic medical centers rated EHR usability lower, on average, than those who worked in VA hospital (43.1 vs. 57.5). 

They also found a dose–response relationship between a doctor's rating of the EHR and being burn out: The higher the score on the Maslach Burnout Inventory, a standardized survey for assessing burnout, the more likely the doctor's ranking of EHR usability was low.

The study, which included researchers at Yale, Stanford, Mayo, and the American Medical Association, found that physicians spend one to two hours on EHR and other desk work for every hour spent with patients, and an additional one to two hours daily of personal time on EHR-related activities.

Edward R. Melnick, lead author and assistant professor of emergency medicine and director of the Clinical Informatics Fellowship at Yale, said EHR’s structured data entry requires physicians to check boxes used for billing that have nothing to do with patient care.

"And looking for communication from another doctor or a specific test result in a patient's chart can be like trying to find a needle in a haystack,” he said