Over a decade ago, the “meaningful use” clause in the United States Affordable Care Act incentivized Electronic Medical Record (EMR) adoption. The purpose of this directive was to improve the transfer of laboratory data to point-of-care clinicians to help us make better, more informed decisions for our patients.
In the years that followed, EMR systems have proliferated globally; countries like New Zealand, Norway, and the Netherlands are reporting EMR usage rates above 90% for primary care physicians. However, from the beginning, there have been documented drawbacks to this technology. Despite the valuable promise of synchronizing patient records across the continuum, the day-to-day experience of EMR users does not match their lofty goals.
The additional strain from implementing multiple redundant systems, manual data entry, and burdensome tasks to care providers has helped fuel the growing physician burnout crisis we find ourselves in today. A majority of physicians—myself included—spend hours at home trying to catch up and input data into EMRs, leaving us with minimal time to spend with our families.
Fixing this problem would revolutionize care—flowing data opens up improved coordination, promotes holistic health, and empowers physicians to practice medicine, not wrestle with IT systems. To accomplish this, why not try listening to the frontline healthcare workers interacting with these systems daily? Our insights can help the industry understand not only the challenges with EMRs but the solutions.
Too many systems, too few data
Health records are designed to be single sources of truth for patient information—interoperable between specialties, health systems, and points of care. However, patient data remains disjointed and incomplete due to the fractured healthcare system we operate in.
According to a poll of more than 260 global HCPs, 52% reported using two or more EMRs—some report using four or more!—to deliver patient care. Using multiple systems undermines the purpose of a single source of truth and adds administrative burdens that distract care providers from treating our patients.
This distraction from care delivery is a common trend. According to the same poll, the amount of time physicians spend on EMRs vs caring for patients is skewed: 26% spend significantly more time using EMRs than interacting with patients. Only 23% reported spending significantly more time with patients than EMRs, while 20% spent equal time with both. The balance between the clinical tools and actual treatment is weighted in the wrong direction.
Despite the hundreds of hours we physicians spend inputting information into the EMRs, the data in the patient’s record is inconsistent or missing. 27% from the poll report need to run their own tests or exams to get the necessary data to ensure complete patient records.
What is the point of patient records if we need to start over every time? These numbers are common and underscore the issue behind EMRs in practice against EMRs in theory. The good news, we physicians have voiced what we want to be fixed. Now it’s time to listen.
The solution: better usability
When interacting with these software systems, usability and unintuitive interface navigation present the most challenges and frustrations. Half of HCPs in the study rate improving EMRs’ usability and interface as their most requested fix. A quarter says consolidating the systems would be most helpful.
Updating the interface would go a long way in improving the user experience and relieving some of the frustrations when using these tools—we might even begin to view EMRs as a helpful tool to complement patient care and exams, rather than a necessary burden. If EMRs can make this shift, the original promise of meaningful use may be fulfilled.
HCPs are wary of Big Tech in healthcare
EMRs are a valuable and integral tool that connects all aspects of patient care. Unlocking its potential will transform healthcare and bring it into the digital age. Not to mention present a large potential revenue stream.
Because of this, tech companies are trying to break into the business of medicine. Apple is integrating patient data into their devices with the Apple Health app and even attempting to create their own consumer-owned health record. Amazon too is making a healthcare play with Amazon Care (though they recently closed this pilot due to challenges with standing up a healthcare arm).
Specific to EMRs, Oracle has acquired Cerner for $28.3 billion. The entry of Big Tech into healthcare records may deliver the needed improvements in usability HCPs are asking for.
It seems like a match made in heaven, right? Healthcare data operation across EMRs requires strict security protocols. While Big Tech companies are successful at creating sleek, intuitive interfaces, I am wary of their entrance into healthcare due to the sensitive nature of the product: our lives. I am not alone.
HCPs are also very wary of Big Tech’s entry into healthcare. More than half (52%) of physicians in the study are hesitant about Big Tech’s ability to operate in healthcare. More extreme, 28% do not trust non-healthcare companies to develop an EMR.
Healthcare is a major market—$1.27 trillion, or almost 20% of the US economy. This size and the importance of its functions are worrying to those that believe healthcare needs to be the main focus for companies, not an additional vertical for expansion.
Healthcare disruption does not have the tolerance for failure when lives are on the line. A crashing webpage for online shopping may be an inconvenience, but a crashing healthcare system has potentially fatal consequences. The need for rigorous testing, fail-safe measures, and security set healthcare apart from all other industries when it comes to digital strategy. Healthcare companies require this high-quality benchmark to be built into their infrastructure even more than we may understand.
Teladoc Health, a virtual care company, announced partnerships with Microsoft and Amazon to expand their telehealth offerings. According to Teladoc CEO Jason Gorevic, “[Healthcare] isn’t a corner of the desk activity for us. I don’t think healthcare lends itself to being kind of a sideshow. It has to be front and center in order to do it well because it’s so complex.”
This type of partnership is how I envision healthcare technology to evolve. With established industry players partnering with tech specialists to bring their expertise into healthcare systems instead of competing.
So, what’s next?
The EMR system may be a large financial incentive for companies, but it is also a huge burden for physicians. All platforms are expensive and very time-consuming—even bringing in any new staff to onboard and teach the system is a challenge. Physicians are already under immense stress due to a lack of time for self-care. We need technology that will relieve these headaches without adding any new issues. But how we reach that destination requires buy-in and trust.
Going forward, healthcare will be more digital. The benefits we saw in virtual care and connected data—though forced to adopt them due to the pandemic—demonstrated the next evolution in care delivery. I am excited and confident that this will be our new normal, but wary of who will lead us into that next generation.
EMRs are only the beginning, but we must pay attention and ensure if any Big Tech companies enter the healthcare space, they play by healthcare’s rules. Move fast and break things may be the motto at Meta (Facebook’s parent company) but should never be a phrase uttered in a healthcare setting.
So, where do we start? By listening to physicians, rigorously testing new technology, and keeping patient safety and well-being at the heart of this mission. Next-generation care will solve many challenges, it just should not also present a list of new ones.
About Dr. Azadi
Dr. Azadi is an established and highly-skilled physician with over 20 years of experience in Internal Medicine with special interest in aesthetics and cosmetic dermatology. She actively performs cosmetic and aesthetic procedures and supervises and trains other doctors, nurse practitioners, and physician assistants at her practice in Austin, TX. She is board certified in Internal Medicine and is a member of the American College of Physicians and Texas Medical Association and of the Sermo Medical Advisory Board.