Latest Senate HELP Committee hearing focuses on physician dissatisfaction with EHRs

The latest Senate Health, Education, Labor, and Pensions Committee hearing focused on physicians' experience with EHRs--widely recognized as a source of significant dissatisfaction.

Sen. Bill Cassidy (R-La.), a doctor himself, told the committee that physicians are spending more time entering data into EHRs and less time speaking to and examining patients. “As a physician, time is better spent looking into a patient’s eyes as opposed to clicking on a computer screen to document something unimportant to the patient but required by someone far removed from the exam room,” he said.

Despite the challenges to patient care, Sen. Sheldon Whitehouse (D-R.I.) said health IT will enable efforts such as the Obama administration’s $215 million Precision Medicine Initiative and the transition to value-based payment models. Health IT is “critical national infrastructure that should be seen just like our highway system,” he said. He added that EHR adoption is necessary to achieve healthcare transformation “but not sufficient and it needs to be done well.”

But, better usability and interoperability for EHRs is required to establish the goal of a learning, improving health system. “There’s a lot of frustration to go around,” Whitehouse said. “We have a lot to learn from providers’ experience integrating EHRs into the practice of medicine.”

Stakeholders shared their experience and thoughts on the situation. Boyd Vindell Washington, MD, president of the Franciscan Medical Group and chief medical information officer of the Franciscan Missionaries of Our Lady Health System in Baton Rouge, La., cited increased data-entry and documentation burdens on physicians, loss of provider-patient interaction and frustration with new Meaningful Use requirements as clinical workflows change. “There’s really been a lot of stress as providers try to meet these requirements.”

Washington recommended adjusting the required documentation for billing and quality to more accurately align with new care models. “Too much effort is spent recreating the attestation and documentation check boxes that existed in the paper world, which are just no longer relevant as we switch to electronic medical records.” Those checked boxes put unnecessary burdens on providers and do not improve patient care, he added.

Meryl Moss, chief operating officer of Coastal Medical, the largest physician-owned and primary care-driven accountable care organization in Rhode Island, made a case for the need for both federal EHR incentive programs and EHR certification standards. “We would recommend that incentive programs continue to reward EHR adoption, interoperability, improved patient access and improvement of performance on quality measures,” she said. “These programs help us to focus on what is most important, and provide revenue for infrastructure support that is in short supply in many physician groups. In addition to financial support, the Meaningful Use program organized providers and vendors around a single set of measures designed to positively impact patient care.”

Moss also said the EHR testing and certifying body Certification Commission for Health Information Technology has helped her organization ensure that EHR products have certain required functionalities.