Surgeons

What Do Surgeons Think About EHRs?

During December 2011, AmericanEHR Partners, in conjunction with the American College of Surgeons (ACS), conducted a survey of ACS members regarding their use of EHR systems and their satisfaction levels with a wide range of EHRs.

A common theme emerged. While surgeons see benefits, the systems they were being required to use were generally designed to work for primary care and medical-related specialties and sub-specialties. While a criticism of the current state, it is a clear indication of the focus of EHR developers and policy developers on meeting the needs of primary care physicians. The specific nuances and requirements of surgeons are not being met in many instances.

Survey responses from over 350 surgeons have been incorporated into the overall AmericanEHR satisfaction ratings and Top 10 list. AmericanEHR Partners is currently preparing the data collected from the ACS survey as well as other specialty surveys already conducted in order to allow filtering of the satisfaction ratings by practice size and by specialty where sufficient data is present (i.e. a minimum of 10 verified ratings for a specific EHR product).

Surgical users also shared comments about their EHR systems. Selected user comments are presented below:

  • After 30 years in active General Surgery Practice, I have now moved into administration and have accepted the position of Chief Medical Informatics Officer for my organization. It presents new challenges as we help guide users through change management. It’s a whole new world and one can’t negotiate it well by “thinking” in paper and translating to the electronic format. Nothing shines a magnifying glass on flawed workflows quicker than installation of an EHR.
  • I can’t state forcefully enough how much I HATE EHR. It impacts our efficiency enormously in a negative fashion causing us to spend inordinate amounts of time focused on documentation to the exclusion of patient care. ERx is definitely a plus but little else is of value. For those of us with specialty training, highly developed diagnostic skills, dedicated to comprehensive care of patients and whose practices treat highly complex patients, this initiative is a huge step backward. I truly believe it limits the quality of care delivered. It’s expensive, time consuming, inefficient, inaccurate, and yet another hurdle to delivering the quality care we have all striven for.
  • I have no other EHR by which to compare this one, and my use of the system is rather limited (mostly direct patient care)  but it seems to work well enough. There are advantages and disadvantages and the system keeps evolving — sometimes I think to its own detriment; however, I think the changes do not necessarily reflect the EHR as much the personnel who manage it.
  • My current EHR seems to have been developed by IT personnel who never spoke to doctors/nurses/ providers as to how they do their work and chart their information. I have had to make major adjustments to adapt to the program rather than the program being developed as to how I practiced. For someone without typing skills it is extremely tedious. Many physicians have looked for alternative methods to generate these records and input them into the EHR. I have used a different EHR program for over 12 years starting in private practice. It was developed by a physician. It works the way I work and the input interface is easy, quick, and often requires little typing. My current EHR remains slow and tedious.
  • The open architecture of our EHR creates an enormous amount of labor for the hospital and the doctors. The EHR has slowed me down as I have to enter and type up everything: my thoughts are distracted from thinking about the patient and what I must do to care for them and diverted towards getting the data entered into the EHR. I feel I need a scribe next to me just to free up my mind. I resent the data entry. I resent the typing. I resent intrusion upon my time. It can and should be better than it is presently.
  • I feel that EHR takes away the “art of medicine.” It is much more difficult to interact with a patient and develop a relationship when you are sitting in front of a computer managing drop down lists to “fit” patients’ complaints and problems.
  • One of the main problems with our EHR is the fact that the system is national. It’s very difficult to get any local modifications. It’s cumbersome and large, but very complete. Overall, it’s good for patient medical records other than if people don’t use it correctly regarding copy and paste. Our ability to code for ICD and operative codes is worse with fewer choices than other places I’ve been and the search is bad.  It’s great for local imaging and labs and graphing functions. Prescriptions are pretty easy. It is hard to reconcile meds from the outside sources. It is also very hard to figure out which scanned in records are what. However, overall, it is a good thing for medical records. The other complaint I have is that all systems and hospitals have changed to a point at which we spend more time on the computer than teaching or with the patient at times. Without the EMR though, I remember the days when patients didn’t know their meds and if there was a chart it was a huge stack of non-collated papers. So in that respect, it is leaps and bounds better.

Are you a surgeon and user of an EHR? Add your thoughts regarding the benefits and challenges.

Comments:

2 responses to "What Do Surgeons Think About EHRs?"
  • January 14, 2012
    Kurt Bamberger
    said:

    I’m a solo practitioner general surgeon and have been using an integrated medical records system for the last 10 years. I believe that many physicians do not completely understand why an electronic medical record system is so valuable. They are lost in the fact that it seems cumbersome to enter the patient’s information. I strongly believe that there is no role for drop-down menus when recording a patient’s history. I continue to use a dictated note as has been done for years, but in my case I use voice recognition to directly import my note into my record system. A computer generated note from drop down menus is really not helpful.
    The fact that a patient must provide each physician’s office with a medical history at each new patient visit is ridiculous during this “age of information technology”. A patient transferred from one hospital to another arrives with hand written scribble is ridiculous in 2012.

    I have worked with a small, user friendly company for 10 years. The system is adaptable and has continued to improve. As a solo practitioner it has been easy to transition my office staff to the current “chartless” status.

    I have sought the opportunity to share my thoughts however no one wants to hear from a solo “country” surgeon. I will continue with my system and continue to enjoy the benefits.

    I would leave this final note: If a doctor believes that an EMR is there to make things quicker and more economical than he will struggle with the transition. If the doctor realizes that the EMR will make the records transferrable and accessable that adoption will be more smooth.

  • February 28, 2012
    Max
    said:

    I attended a session on EHR selection at the 2010 AAO meeting. The presenters were from a large practice in the Southeast. The administrator of the practice was lawyer with tremendous business experience; they had a full time IT person. The lawyer was probably getting paid more than I am. We have a medium sized practice, 4 MDs, 2 ODs, 3 offices, and we can not afford to hire a lawyer to run our practice, or to hire a full time IT person. We did fairly thorough due diligence, we think, and decided to choose our EHR. It is pricey and complicated. We have just begun the 6 month process of implementation. It will probably be 12-24 months before we know if we made a good decision. The AAO could help by not being so vague about these products. How about an AAO analysis, a la Consumer Reports, that ranks the EHRs, shows their prices, and selects Best Buys, etc. That type of service by our national organization would be invaluable.

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