South Florida Hospital News
Thursday June 27, 2019
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September 2018 - Volume 15 - Issue 3

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Medical Students Have Frustrations With EHRs Too

Often, physicians voice many concerns about the electronic health records (EHRs) with which they are directed to work. One hears that the EHRs do not facilitate a clinician’s workflow. They are not physician friendly because physicians’ input was not solicited. They were designed for billing, not for patient care. Data is in different forms, structured and unstructured. Many older physicians are not as familiar adapting to technology as younger people. Clinicians spend countless hours at a computer screen which adversely affects the time that they can spend with their patients. Their patients would rather look at their physician rather than have him or her looking at their computer screens when he or she is in their office.

Well, what about millennial medical students? Most are certainly tech savvy, but they also seem to be experiencing frustrations with EHRs. Many medical students may be trained in a number of EHR systems during their clerkships, using different systems than their classmates in other placements. This makes EHRs impossible to truly integrate in amedical curriculum. Medical students find they are spending time on required documentation rather than learning the system itself, given that training is time consuming. The systems that the medical students train on may not even be the same systems they have to use when they are residents. Often, students view the systems they have to use as counterintuitive and there is a steep learning curve.
 
At the bottom of the hierarchy, medical students are left to navigate the inefficiencies of the EHR. When there are discrepancies from outpatient records, students are assigned to call outpatient offices and speak with providers directly. The medical students might be asked to fax HIPAA forms and obtain records from private practice, ostensibly acting as a gofer in the process for record reconciliation. They often feel that they have to wait for the resident to do certain things, such as access orders or update progress notes. Students may feel that inefficient EHRs are costing them time and therefore their educational experience.
 
However, medical students are quite enterprising and clever, and thus, they have learned to develop some “work-a-rounds.” Complicated EHRs have forced students to use outside technology to help prepare presentations and present plans for patients. Often, students write their notes identified in separate documents and email them to their residents for their reference or feedback. Many times students will rely on providers directly for a summary on new patients, as navigating the chart is time consuming and incomplete. It is too convenient to use other systems rather than even optimize use of the current EMR.
 
Students may yearn to have input in the design of EHRs, which might have made the systems friendlier. Being tech savvy, medical students might even want access to information technology departments and EHR representatives, but their calls for input, like those of physicians, are generally not heard. In this way, we limit the input for use improvement of a new generation of users.
 
Thus, it appears that even tech savvy medical students, who might even have learned the technology, experience many frustrations with EHRs. Although they may be better suited to adapting to EHR platforms, they too appear to have similar concerns. The fact that they may have an easier time learning an EHR system does not necessarily mean that in 20 years we will have a cadre of new physicians who are happy with the current EHR systems and how they affect the practice of medicine. It may be more likely that if EHR vendors develop more clinician friendly systems and clinic placements all use the same system, there may be a cadre of physicians who are somewhat content with their EHR platforms. Unfortunately, this may not be on the horizon.
 
Paul R. DeMuro, Attorney at Nelson Mullins Broad and Cassel, can be reached at paul.demuro@nelsonmullins.com.
Ruchik Patel is a Fourth Year Medical Student in New York, NY.
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