Electronic health records contributing to physician burnout

Improving the EHR is a cause physician and nursing leadership must take on, because they are the only ones who stand to benefit.

There is no financial incentive for existing EHR companies to reinvent their products, and little interest on the part of medical administrators in new technologies that do not directly contribute to the financial bottom line. Neither can we depend on government health ministries, who are already receiving the aggregate data provided by current EHRs in order to manage the healthcare system.

Reading Dr. Wachter’s call for reimagining the electronic health record to take advantage of technology “without slavishly replicating the old paper-based …workflow,” I was reminded of Dr. Lawrence Weed’s work in the 1970s to promote the Problem-Oriented Health Record as an alternative to the standard practice of paper chart documentation. The POMR was a superior system in concept, but required computer technology (not available at that time) to be practical and efficient.

Recently I led a team which created a practical EHR (konote.ca) based on Weed’s Problem-Oriented concept, and enhanced it by integrating narrative and quantitative data in the same note, and adding data visualization tools that engage the patient. Early adopters are excited by the novel, but these are clinicians – and the market reality is that clinicians do not buy these systems, administrators do.

Physicians must lead. I hope the CMA takes up the challenge.

David Gotlib MD FRCPC
Psychiatrist
Toronto Canada