The EMR and Physician Burnout

Ask any physician what the most frustrating aspect of their work is and a majority will start to gripe about their Electronic Medical Records (EMRs). Ever since their inception in 1979 and then laws mandating an industry-wide adoption of electronic health record systems by 2014, EMRs have become an indispensable part of our healthcare organizations. In fact, the American Recovery and Reinvestment Act (ARRA) put out by President Obama didn’t just encourage EMR use, but also provided additional funding to professionals who adopted them. What originally seemed like a brilliant way to streamline the collection and dispersal of patient health information, has arguably ended up causing more frustrations for those working in the industry and patients alike.  

It seems like every other day there is an article published on the frustrations of EMRs. Clinicians complain about spending more time in front of screens than with their patients. Recently researchers at Stanford Medicine analyzed nearly 16 million interactions and found that medical trainees spend “an average of 5.38 hours - or nearly half of a 12-hour work day - in front of a screen.” The same Stanford researchers found that the largest chunk of time on the EMR was spent looking for information. EMRs are designed in such a way that they are complicated and hard to dig through, making it so that doctors have to click too many buttons and read many unstructured text fields to find the right information. It becomes an overload of information. The idea with EMRs was to make it easy to find patient health information; right now, it is quite the opposite. 

This all leads to physician burnout, which has now become a pervasive issue (NBC). In fact, a majority of physicians are experiencing burnout symptoms, with 40% testing positive for depression and 7% reporting to be suicidal. The emotional exhaustion and depersonalization that comes along with this of course ultimately leads to lower quality care for patients as well. Atul Gwande, world renowned surgeon and public health researcher’s, New Yorker piece titled “Why Doctors Hate Their Computers” delves deeply into this issue as he documents how the hospital system where he works, Partners Health Care, spent $1.6 billion upgrading to the EMR system, Epic. Unsurprisingly, he finds that the amount of time a clinician spends on computer documentation is one of the strongest contributors to these epidemic levels of burnout. He reports that doctors found themselves “subject to a system that controlled their lives.” 

Nevertheless, EMRs are not all bad. They have in fact made it easier to share health information between different physicians and their patients almost instantly, driving down costs and increasing efficiency and coordination, of course with limitations. They have minimized errors that came from hand-written documentation and have also made it easier to comply with patient privacy and security laws laid out through the Health Insurance Portability and Accountability Act (HIPAA).  Dr. Gawande concludes that while there are these benefits of using such technologies in medicine, it is important that these systems make care simpler and strengthen human connection, instead of weakening them. 

Still, as Dr. Gawande reports, and as Trayt’s CMO Dr. Carl Feinstein states, what we must realize is that fundamentally EMRs are for billing purposes and not for improving patient outcomes. In other words EMRs serve as a documentation for reimbursement from insurance companies. They are not comprehensive or user-friendly enough to capture patients’ holistic data in a way that is effective for care, and thus, they are not designed for improving health outcomes.

That’s where Trayt comes in. Our goal is not to be another EMR system that takes away from quality doctor and patient facetime. Trayt focuses on outcomes and understanding life influencers that interact with symptomatology. Our comprehensive datasets and curated reports on patients in between visits makes it so that clinicians spend less time looking at their screens and can instead focus on what matters. On top of that, clinicians know exactly what specific symptoms to ask about and whether treatments are really working or not. 

We need to minimize how long doctors are spending in front of their computers. More importantly, we need to ensure that the time they do spend is translated to effective and efficient care.