Complicated problems often come with a craving for simple explanations. In the field of healthcare, doctors usually turn their frustrations towards their electronic health records.
Introduction
The average duration of EHR use for every eight hours of scheduled patient care is about six hours, with almost half taking place after the clinical hours. The turning, switching, clicking, and typing, which are done repeatedly, together with all the associated difficulties, lead to exhaustion and burnout.
Nevertheless, medical personnel still consider EHRs as the source of most of the challenges and difficulties they encounter at their workplace. This view is not only simplistic but also very distracting. Allow me to elaborate on my point.
EHRs Are A Mixed Bag
In fact, EHRs perform a dual role. They make some operations easier to perform, while on the other hand, they make others harder. For instance, they provide us with the necessary info and simultaneously inundate us with junk and rubbish. Moreover, clinical notes are now readable and accessible, but often contain a lot of unnecessary, repetitive, and sometimes unintelligible content.
In a like manner, EHRs have put us closer to patients, yet at the same time, they have pushed us away. Digital portals simplify our communication during the visits; however, the presence of the screen and the keyboard in the examination room creates a barrier to the person-to-person ratio.
EHR makes some tasks more productive while making others less productive in the process. Electronic prescription of medications and communication of test results are now easily done, yet at the same time, the EHR forces us to filter through numerous alerts and notifications.
EHRs Never Operate Alone
EHRs, healthcare professionals, and procedures interact to create socio-technical systems. It is no longer a matter of simply blaming EHRs for the difficulties in practice—they are not the only components of the system to be taken into account.
In the process of adopting EHRs, a lot of organizations digitized their entire process, going from paper to electronic, which resulted in the medical staff and nurses having to come up with their own ways of doing things and carry on with some unnecessary tasks. Conversely, organizations that altered their workflow and reorganized their staff have been able to achieve great things. For instance, primary care doctors who are part of high-performing teams are able to spend less time on the EHR for each patient visit by as much as 14 minutes.
The way the EHR is configured in organizations also affects the experiences of the clinicians. To illustrate, doctors in emergency medicine at one hospital have to click 14 times to prescribe Tylenol, which is quite a lot. However, those from another hospital using the same EHR system have to click 61 times!
Moreover, in some organizations, more than 85% of the clinicians are happy with the EHRs. These organizations have supportive cultures and EHR governance groups that look for solutions instead of immediately rejecting requests for improvements, which is the case in the hospitals that have negative cultures.
Digital transitions are difficult for every industry
The difficulties of digitization are not specific to the healthcare sector alone. While the “world eats more software,” the entire world of knowledge workers is being tortured by the same digital means that decode the information, make a worker cope with many tasks at the same time, and increase the work rate. These workers usually give negative ratings to their enterprise software (for example, Concur, Teams, and Workday) and, just like doctors, often work during nights and weekends.
Healthcare Is Gradually Becoming More Complex
To put it differently, if EHRs (Electronic health records) are not the major problem, then what is the doctor’s feeling about his practice being so tough? To put it in the words of James Carville, “It’s the complexity, stupid.”
First of all, our patients’ health needs get more complicated. Almost half of the adult population in America is suffering from at least two chronic diseases, a third of them take no less than three medications, and one out of five suffers from mental illness.
The clinical pathways and protocols are getting more complex, too, and a general practitioner would have to work 27 hours every day to provide preventive, chronic disease, and acute care according to the guidelines to a 2500-patient panel.
The administratively more complex healthcare system in the USA has various regulatory and billing demands, along with concerns over medical-legal issues. This partly accounts for the average U.S. clinician spending as much time with EHR as, on the other hand, a non-U.S. clinician who is in the 99th percentile for EHR work.
What needs to be understood is that non-technical factors contribute significantly to the perceived EHR burden. To quote A Jay Holmgren from UCSF, “The EHR is a conduit for this work, but not the cause of the work.”
Complexity Impacts Usability
Many medical practitioners have a legitimate reason to lament that their EHR systems are not the same in terms of user-friendliness as applications like Gmail and Spotify. Nonetheless, consumer technologies are made to accommodate the needs of individual single users and to curtail their decision-making power. On the other hand, electronic health records need to be sophisticated enough to be on par with healthcare’s complex adaptive systems and to allow the skilled staff to take over the autonomous making of decisions. Moreover, some EHRs, like Epic, adopt a monolithic architecture that brings together the very different applications and features to ensure the trustworthiness of the whole system. In these instances, the featureless characteristic is deemed a benefit rather than a disadvantage.
However, it should be noted that not all the time spent in EHRs is unproductive! We quickly and easily overlook the fact that the usage of EHRs is much more than merely pointing, clicking, and typing. While working with EHR systems, we are actually processing and integrating information, mastering the art of critical thinking and communication with coworkers, and at the same time, performing a variety of activities that were around long before the advent of EHRs. In fact, the situation is quite the opposite; we have not diminished patient interaction in today’s medical practice compared to the last sixty years.
We Must Avoid The Trap Of Technological Solutionism
This does not imply that EHRs are flawless; they are not, and we are entitled to a more user-friendly technology. Nevertheless, it is hard to place the blame on EHRs as they are such a prominent issue in the foreground.
Wringing the EHR’s neck for the hurdles in clinical practice leads us to pin our hopes on the hype of technological silver bullet solutions like AI. But as the famous artist Laurie Anderson puts it, “If you think technology will solve your problems, you don’t understand technology—and you don’t understand your problems.”
The issues in the healthcare sector are mainly social, behavioral, and economic, rather than technical. The majority of problems connected with EHRs are just reflections of these underlying issues. Thus, instead of constantly complaining about EHRs, we should redirect our efforts towards redesigning care systems, making our work more efficient, adjusting team sizes, and clarifying what is really important.
Frequently Asked Questions (FAQs)
Why do clinicians often blame EHRs for workplace difficulties?
Because EHRs are the most visible part of daily workflow, clinicians naturally associate frustrations with the system—even when deeper organizational or systemic issues are the real cause.
Are EHRs inherently flawed?
Not inherently. EHRs have strengths and weaknesses. They streamline many tasks but also introduce new challenges, especially when poorly configured or integrated into outdated workflows.
Why do EHRs feel more complicated than consumer apps?
Consumer apps serve individual users and limit choices. EHRs must support complex clinical decisions, regulatory requirements, and team-based care, making them inherently more complex.