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ED Docs Spend More Time With EMRs Than Patients

Emergency department doctors spend substantially more time entering data into EMRs than they do interacting with patients, according to an American Journal of Emergency Medicine study reported by FierceEMR.

According to FierceEMR, the study found that the average percentage of time ED docs spend on data entry was 43 percent. During a 10-hour shift, researchers concluded, total mouse clicks neared 4,000.

In contrast, the amount of time emergency department doctors spent interacting directly with patients during the AJEM study was 28 percent, the researchers found.  Meanwhile, reviewing tests and records accounted for an average of 12 percent of the doctors’ time, and talking to colleagues consumed 13 percent.

It’s hardly surprising that doctors would rack up nearly 4,000 clicks during a shift. Mouse clicks for common charting functions and patient encounters range from a low of six clicks for ordering an aspirin to a high of 227 for completing a record for patients with abdominal pain through the point of discharge, according to an article in Medscape Medical News cited by FierceEMR.

These results are consistent with those of a similar study published earlier this year in the Journal of General Internal MedicineiHealthBeat reports. According to iHealthBeat‘s story,  researchers who observed 29 medical interns at Johns Hopkins Hospital in the University of Maryland Medical College found that the interns spent 40 percent of their time on computer related tasks, and 12 percent of the time talking with and examining patients.

Such reliance on EMRs in the ED may have some benefits, but there are also risks involved,  according to a recent study appearing in the Annals of Emergency Medicine. According to the study, the design of EMRs for emergency departments varies widely, with some having problems which can compromise clinician workflow, communication and ultimately, quality and safety of care.

The Annals research suggests that hospitals ought to be auditing the performance of their EDISs regularly,  given how central these tools are to emergency medicine these days.  If doctors are going to click nearly 4,000 times during a single shift, it’s best if the EDIS in question doesn’t foster communication failures, alert fatigue or wrong order/wrong patient mistakes, all problems which emerge when the EDIS doesn’t function well, researchers concluded.

October 2, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Hospital EMR and EHR Advertisers

It’s been a really exciting period for Hospital EMR and EHR. I’ve been really proud of what we’ve built. Anne Zieger has been writing some really great content and I try to supplement it where I can. Thanks to that, the site has had a steady stream of traffic and we’ll soon have over 1000 email subscribers from most major hospital institutions. Not too bad for a relatively new blog that’s focused on such a tight niche.

Plus, we’ve recently gotten the support of a number of really amazing advertising partners. Without them, the work we do covering the hospital EMR and EHR world wouldn’t be possible. So, if you enjoy reading this site, then please take a moment to check out the following new advertisers.

Canon – I think we’re all quite familiar with Canon. They’re a great company that creates a lot of great products. The best product they make for healthcare is their high volume scanners (Although, I bet their printer division might argue this). I personally have a Canon high volume scanner by my work desk and I love it. While we’d love to get rid of paper in this new EHR world, it’s just not possible. So, a high volume scanner is a must. The Canon scanners are well worth checking out.

iChartsMD – iChartsMD recently launched their new Emergency Deparatment EHR software. They’ve been working hard in the EHR space to offer an affordable EHR that still can handle a fast moving workflow environment like in the ED. If you’re looking for an ED EHR solution, take a moment and check out what iChartsMD has created.

Caristix – When I first met Caristix, I could immediately tell that they were HL7 Interface experts. Everything about them, their website, and even their detailed HL7 Survival guide is focused on making HL7 easy for healthcare. Kind of reminds me of my post about the need for Interoperability Action, Not Talk. In order to make this a reality, we need more companies like Caristix that make HL7 interoperability easy.

A big thanks to all of these advertisers for their support. Also, thanks for reading the site. None of these advertisers would support us if you didn’t read. Hopefully we can continue to bring you great content about the crazy, fun, and exciting hospital health IT space.

February 25, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Applying EHR Technology to Bad Hospital Processes

I’ve written many times on EMR and HIPAA about the need to fix the internal workings of your practice before you implement an EHR. The problem being that technology like an EHR work like a great magnifier of any problems with your practice. Something that you may not have noticed as an issue in the paper world can often become a major problem in the EHR world. Not because the problem shouldn’t have been fixed in the paper world, but because you didn’t realize it was a problem.

The core point being, “EHR Technology doesn’t solve bad processes.”

With that as background, I started to think about this from a hospital perspective. Yes, in a small practice it’s much easier to evaluate the relatively simple workflows and dramatically improve them. The same thing is MUCH harder in the incredibly complex hospital world.

In the hospital environment, I expect there are always processes that need improvement. Plus, in many cases the health system is so hardened into its current practices that changing those workflows is almost impossible. This workflow hardening means that hospital EHR vendors are often beholden to old, outdated processes and workflows.

Related to this problem is the view that many hospital EHR vendors (Epic being famous for this) hold about implementing one system across the entire hospital. While you can certainly see advantages to one system, I think a major downfall is that it often means that workflow improvement is much harder.

Those ED EHR vendors have certainly seen this first hand. Imagine how much time and focus a one size fits all hospital EHR spends on an ED EHR module versus an ED EHR vendor that only does ED EHR software. Which of those do you think has a better chance of helping an ED get to the optimal ED EHR workflow? The answer is obvious. Now extrapolate this same concept to the thousands of other workflows that exist in a hospital.

We’re more likely to see hospital innovation from a number of scrappy highly focused startup companies than we are from large hospital EHR vendors. Although, the smartest hospital EHR vendors will realize this and will open themselves up to scrappy highly focused startup companies to iterate on top of their hospital EHR platform. Too bad far too many are focused on putting up walls as opposed to creating highways.

June 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.