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Doctors in Chains: The Unintended Consequences of Electronic Patient Records


 Electronic patient records

In the digital era, every sector is pushing to go paperless, and healthcare is no exception. Electronic patient records (EPR) promise efficiency, data accessibility, and a move towards a more streamlined healthcare provision. However, this movement has its drawbacks. Alarmingly, doctors are finding themselves entrapped in a web of data, morphing from healthcare providers to data clerks, with consequences on doctor-patient relationships, professional efficacy, and the overall quality of care.


Five years ago, a UK NHS consultant could read and triage a GP referral in 60 seconds. Writing an admission card for a medical procedure took as long, and a new patient consultation could be effectively conducted in 15 minutes. However, these seemingly efficient procedures have dramatically changed with the advent of EPR. Today, the same tasks demand more than double the time, with doctors spending between 5 to 10 minutes on a GP referral, and 30 minutes to electronically book a medical procedure.


These numbers are staggering, reflecting a concerning drop in efficiency. In one hospital, a doctor needs to make a whopping 120 clicks on the EHR system before even seeing a patient in outpatients. The medical profession, once synonymous with hands-on patient care, now appears intertwined with screens and keyboards. What's gone wrong?


The root of the problem lies in how EPR systems have been designed and implemented. While the premise of digitising healthcare is noble, the practice has proved far from perfect. Doctors are drowning in a sea of clicks, checkboxes, and text fields, burdened by the time-consuming administrative tasks that draw them away from their core responsibility: patient care.


Unlike the salaried staff in the NHS, where income and benefits are not directly tied to patient numbers, private medical practitioners feel the impact much more acutely. In private practice, time is literally money: fewer patients per hour translates to less revenue. This reality has created an urgent demand for EPR systems in the small to medium size health providers that, unlike their hospital counterparts, are designed from the outset to outpace traditional paper records and improve, not reduce overall efficiency. Herein may lie the key to success. If we make IT systems work in the real world of competitive small clinics perhaps such systems can be scaled up for hospitals, not vice verse.


There is no doubt that the digitisation of healthcare records is crucial for advancing modern medicine. EPR systems, when optimised, could potentially speed up medical procedures, enhance data sharing, and contribute to medical and quality audits. But the situation to date paints a bleak picture since if small clinical providers adopt mini versions of large hospital EPR systems, they would mostly certainly fail.


What we need is a shift in the design philosophy of EPR systems. It’s time to reimagine these systems with the end-user, the healthcare professionals, at the forefront. We need technology that enhances their work, not encumbers it. We must build systems that balance the need for data and audits with all healthcare professional's essential need for efficient workflows. The goal should be to create an intuitive, user-friendly interface that minimises administrative burden while still delivering the benefits of digitised records. In short, we need data systems that increase medical productivity, not stifle it.


It’s time to unchain our doctors from the excessive demands of EPR. We must strive to create an environment where technology serves its intended purpose: aiding, not hindering, healthcare professionals. The promise of EPR is vast, but realising that promise requires thoughtful design and user-oriented implementation. Only then can we ensure that our doctors are released from their digital chains and able to refocus on their primary mission - to provide the best possible patient care.

Sources:

- [Campion TR Jr, Waitman LR, May AK, Ozdas A, Lorenzi



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