Top challenges of 2022, No. 2: Electronic Health Records

Medical Economics Journal, Medical Economics January 2022, Volume 99, Issue 1

Editor's Note: The past year has been one of the most challenging on record for U.S. physicians. After the lockdowns and telehealth surge of 2020, the year 2021 has been strange. Although things went back to “normal” in that most practices resumed seeing patients in person, the COVID-19 pandemic and its challenges remain. As we do each year, Medical Economics® surveyed our audience to find out what the big challenges were. By far, the top answer was “administrative burdens” including staffing, prior authorizations and electronic health records (EHRs). We decided to take a closer look at what these burdens entail, to help physicians get ready for whatever challenges 2022 will bring. Here's number two.

Since their introduction, EHRs have been a perennial issue for physicians across all specialties. From user experience to interoperability, nearly every facet of the computer-based systems has drawn the ire of those using them.

A recent study found that the amount of time spent in the physician’s inbox and total time using EHRs were associated with higher physician turnover. However, it was found that less time spent on EHR-based tasks was correlated with a higher rate of physician turnover.

Despite this finding, physician burnout tied to EHR use is greater than initially anticipated. The American Medical Association found that EHRs contribute to between 11% and 60% of the burnout physicians experienced in 2021. With the implementation of new information-blocking rules — aimed to prevent EHR vendors from interfering with record access or exchange — from the Office of the National Coordinator for Health Information Technology on the horizon, 2022 has the potential to be another year of EHR frustration.

Tips to improve EHRs

David Lareau, CEO of Medicomp Systems, says medical practices can combat the burnout associated with EHR use by focusing on these four core areas for improving their systems.

  • Improving patient care: Incorporate technological tools that work behind the scenes to capture and interpret billing and coding detail. Streamlining work flow in this area can help physicians quickly find medical information they need to achieve better health outcomes for patients.
  • Increasing physician productivity: Work flows supporting the automatic identification and interpretation of medical information from previous sessions, inpatient records, laboratory reports and other sources allow physicians to focus on the patient instead of their computers. EHRs should not disrupt the way physicians think and work.
  • Ensure accurate reimbursements: Rather than using inefficient, error-prone manual methods, practices should incorporate technologies that prompt the physician at the point of care when patients have potential hierarchical condition category conditions, allowing the doctor to immediately address treatment, documentation or coding gaps while the patient is in the room rather than during a follow-up appointment.
  • Reducing operational expenses: EHR systems can reduce operational expenses by enhancing clinician productivity and streamlining documentation, coding and billing processes. Documentation tools that support quick, efficient capture of visit information at the point of care can reduce or eliminate the need for transcription services.

Integrating apps

The new frontier of EHRs is the ever-growing number of apps available to be integrated into the systems. There was a 20% increase in the number of EHR-integrated apps available across app galleries operated by Allscripts, athenahealth, Cerner Corporation and Epic Systems Corporation in 2020, according to the Office of the National Coordinator for Health IT.

Of the available apps on these platforms, 42% handle scheduling, check-in and billing, 38% of available apps handle clinical functions, 31% handle care management and 20% deal with patient engagement.

Micky Tripathi, national coordinator for health information technology at the U.S. Department of Health and Human Services, says these apps are the key to unlocking more functionality from EHR systems and directly addressing physician frustration. “What (the introduction of these apps says is) that your EHR should be more of a platform than it is a closed software system,” he said. “I see my EHR as a conduit to more…apps that make life better for me, and that also allows individual providers to tailor their experience a little bit.”