​​Will we one day look back on physicians being overworked by the electronic health record (EHR) in the same way we currently look at physicians neglecting to wash to their hands? That's a question posed by an MD and associate professor of medicine writing in the November 14, 2017, New York Times. It was long known that soap and water were the best disinfectants, the author wrote. “However, it took medicine more than a century to incorporate hand-washing as one of the best investments in our patients' health," the author wrote. “Let's hope it takes less time when it comes to common sense and the [EHR]." Healthcare “has devolved into a busywork-laden field that is slowly ceasing to function," the author says, noting studies that show doctors spend more than half of their time interacting with the EHR and more than twice as much time on the EHR as they do with patients. Many of the author's colleagues are saying administrative burdens have become so great that they cannot adequately care for patients. More and more doctors are beginning to believe the EHR actually harms patients, the author said, because it makes them less of a priority. “Medicine traditionally puts the patient first," the author writes. “Now, however, it feels like documentation comes first." The author suggests fining hospitals for requiring physicians to spend too much time in the EHR, the same way they are penalized for hospital-acquired infections or readmissions. “Hospitals might then think twice before tossing in 10 more required fields that cover their own needs but end up leaving patients with even less attention from their doctors and nurses," she adds. The EHRs themselves should be treated like any other medical device, she says, and makers should be held accountable if excessive documentation causes damage to patient care. “If patient safety — and patient satisfaction — truly are goals of 21st century medicine, then we need to rethink how we view the [EHR] and the related electronic burden on clinicians," the author writers.

HRC Recommends: Appropriate use of EHRs requires significant planning and workflow assessment, including involvement of frontline users in preparation; thorough training and support during and after implementation; periodic review of EHR use and feedback; and ongoing monitoring and improvement. Physician time spent using EHRs is one metric that organizations may use for improvement projects, such as those used to reduce physician burnout.