EHRs affect physicians, staff members differently

Electronic health record (EHR) systems affect the workflows of small-practice physicians mostly negatively, whereas the workflows of their staff members are generally improved, according to recent research.

Investigators spent 9 to 14 days over a 4- to 8-week period observing practice workflows, interviewing patients, and collecting documentation at 7 community-based, primary care practices throughout the northeastern United States.

They found that staff clinical and clerical burdens, such as check-in and the rooming of patients, were reduced by EHRs. Communication among staff, patients, and providers also was improved. Although EHRs reduced some physician burdens, such as prescribing and lab ordering, those timesavings were mitigated by increased documentation and quality reporting requirements.

Other findings were that staff routine enabled EHR vendors to develop system workflows that to some degree could enhance and improve primary care practices. The researchers also discovered that clinical workflows for primary care physicians (PCPs) are more complex and unpredictable, which makes it difficult to create EHR workflows for PCPs that work well from 1 practice to the next.

The researchers recommend that EHR developers focus on clinician charting, disease management, and ordering/reviewing tasks because these are the main sources of increased EHR-related work burden. They also concluded that as EHR vendors develop new systems and improve existing systems, they should try to better understand the complex needs of the PCP.

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