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Electronic health records contributing to physician burnout

Roger Collier
CMAJ November 13, 2017 189 (45) E1405-E1406; DOI: https://doi.org/10.1503/cmaj.109-5522
Roger Collier
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  • EHRs: physicians must lead
    David A Gotlib
    Posted on: 03 January 2018
  • RE: EHR and physician burnout
    Pol Morton
    Posted on: 21 December 2017
  • Posted on: (3 January 2018)
    Page navigation anchor for EHRs: physicians must lead
    EHRs: physicians must lead
    • David A Gotlib, Psychiatrist, n/a

    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....

    Show More

    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

    Show Less
    Competing Interests: Developer of KoNote, an EHR system mentioned in my letter. KoNote is a nonprofit venture.
  • Posted on: (21 December 2017)
    Page navigation anchor for RE: EHR and physician burnout
    RE: EHR and physician burnout
    • Pol Morton, Hospitalist, Burnaby Hospital

    I agree with Roger Collier. On many occasions I have heard immigrant doctors from Ireland, Great Britain, South Africa and Australia express surprise at the poor quality of EHR available in North America. EHR has its problems but it should speed up charting, prescription refills and billing. If it does not do so the problem is with the software not the physicians using it.

    Competing Interests: None declared.
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Canadian Medical Association Journal: 189 (45)
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Vol. 189, Issue 45
13 Nov 2017
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Electronic health records contributing to physician burnout
Roger Collier
CMAJ Nov 2017, 189 (45) E1405-E1406; DOI: 10.1503/cmaj.109-5522

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Electronic health records contributing to physician burnout
Roger Collier
CMAJ Nov 2017, 189 (45) E1405-E1406; DOI: 10.1503/cmaj.109-5522
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