Since the town hall event hosted by the AMA and Medical Association of Georgia last month, physicians’ stories about burdensome meaningful use requirements and cumbersome electronic health record (EHR) systems have been pouring in. Here are a few stories that struck me. I suspect that several of these situations will sound all too familiar to you as well.
Family medicine in Indiana
“I thought I’d love EHRs—I’m a stickler for detail, I hate reading handwriting and I love using data to improve my medical practice …. But as I struggle to work around my second EHR in as many years and look toward an impending switch to yet another EHR next year, I feel that I am typing my way into burnout. Instead of spending my days listening to patients and solving their problems, I feel that I spend most of my time struggling to make unique stories and needs fit into an arcane system of clicks and drop-down menus.”
Hematology/oncology in Michigan
“I must make [a choice] between direct care for sick, needy, dying and suffering patients, and the need to satisfy the many EHR requirements to complete the visit …. The health of patients is taking a back seat to the need to chart ostensibly to satisfy administrative, regulatory and financial needs. “I am considering accepting a financial penalty by not participating in [meaningful use Stage 3]. I worry about my own care as I age (56 and counting), knowing my care will be delivered with focus on data entry and billing accuracy, a path towards which we are currently heading. This has become a 24/7/365 career just to keep up—not what I anticipated or previously experienced. I cannot let my patients suffer [from] this—they do not deserve it.”
Cardiology in Kentucky
“I am struggling to keep my office doors open. Since implementation [of my EHR] …. We are much less efficient, much more stressed and certainly financially worse off …. The hope of integrated availability of medical information throughout the country (or even in the same town) was entirely false. The system is totally ruined, and I see no light at the end of the tunnel except to pay off my current lease in August 2018 and close the doors. I love practicing cardiology, but I simply cannot afford to.”
Emergency medicine in North Dakota
“I started using [an EHR] in residency. I had to document for eight hours after my shift, so now an 8-10 hour shift is a 16-18 hour shift. I was so burnt out by the end of my residency [that] I no longer really wanted to be an emergency physician. I still have not fully recovered from that and still get stressed easily …. Many days I just want to quit and go into something else. I have many colleagues that feel the same way. Medicine is no longer worth it.”
Internal medicine in South Carolina
“It has been very difficult for me as an older physician to do all of the necessary EHR tasks in a timely fashion …. My time for a routine office visit increased from 15 minutes to 30 minutes, cutting my productivity in half …. Even though I love my job and wanted to work more years, I am retiring … spurred on by this EHR disaster. Gone will be 35 years’ worth of experience in outpatient general internal medicine.”
These stories are devastating, but they are sadly similar to others I’ve heard from physicians across the country. The physicians quoted above recognize that EHRs have potential, but government regulations have made them almost unusable. As a result, good doctors are leaving medicine, we’re wasting valuable time and patients ultimately will lose out.
Physicians will always ensure that our patients’ clinical needs are given greater importance than meeting federal regulations. Based on our study with the RAND Corporation, we know EHRs are a major driver of physicians’ dissatisfaction with their practice environments. As a result, we worked with doctors and other experts to create eight priorities for making EHRs usable. These priorities continue to serve as a guide for our activities with vendors, policymakers and health care systems.
I need you to share your story with us. Contribute your experiences and help us drive home this issue with D.C. policymakers through a groundswell of physician input. Do not sit on the sidelines. This is urgent, and we need your EHR experiences and stories—how EHRs and current meaningful use regulations have impacted your practice and the care you provide your patients. Then email your members of Congress and ask them to halt Stage 3 of meaningful use until the program is fixed.
Several government reporting programs, including meaningful use, will soon be realigned. The problem is that the government seems poised to do so without addressing these fundamental issues first. We need regulators to hit pause, fix the problems and make the meaningful use program actually meaningful.
Visit breaktheredtape.org to watch the town hall meeting, share your stories about EHRs and meaningful use, and contact your members of Congress.
