As a clinician, I totally agree with these findings. In the old days, clinician writes down what they want to describe for each patient freely in the blank paper including the provisional diagnosis which may be not categorized into the diagnosis code. Writing down in the paper doesn’t take a lot of time and it can be finished at the worksite.
When the EMR era has come, all inputs into the systems come from typing into the computer and when we need to draw a picture it usually difficult to draw and label on the picture for describing physical examination. Furthermore, entering the diagnosis to the system usually use ICD 10 code, that needs higher knowledge than basic diagnostic term, to fill in the blank. If the ICD code does not correct, users are not allowed to skip to another step and maybe cannot finish the EMR.
Also, the laboratory order and medication use the correct name that matches with the database in the system and may need to key 1 time for one order, not one set of order.
All of the above takes a lot of time for physicians to focus on the EMR not on the patients and may influence the physicians to lose eye contact and human touch for patients during the work. Some of the physicians leave the EMR job during the on-duty time and complete it after hour. As it takes a lot of time and decreases the duty-free time the physicians feel burnout for doing this, they think not important, things.
My suggestion to avoid burnout of physician on EMR is
– Use technology to create the input easily such as voices that can convert to typing, use the precise stylus to draw and label findings in physical examination
– Diagnosis term in the database should be a combination of medical diagnostic term and ICD 10 and also use the free text column if the diagnosis given by the physician is not matched to the database
– Laboratory order should be typed as an individual and a battery of common test, the list of the test should be list by frequency of use for easily findings
– Medication order should be allowed to type both generic and tradename to find the medication and have a standing dosage and frequency for easily order. In addition, if physicians want to correct the dosage it should be done easily with the physician’s common term, not the text book’s common term