- This topic has 24 replies, 17 voices, and was last updated 2 years, 6 months ago by Saranath.
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2021-09-22 at 10:00 pm #31549SaranathKeymaster
You have learned the benefits of Health Information Exchange. The Electronic Medical Record (EMR) is one of the basic structures in order to exchange information among different departments/organizations.
Recently, there are many reports stating that EMR is one of top leading causes of physician burnout. Here is an example:
https://www.gsb.stanford.edu/insights/many-health-care-workers-are-emotionally-exhausted-technology-may-be-blame . The article states that “Outpatient physicians now spend twice as much time on electronic records as they do with patients.” and “Technology innovations offer many benefits, such as enabling understanding of digital ‘signatures’ of patients’ health to determine their care. But the same systems may lead to emotional exhaustion, or burnout, among providers, which increases opportunities for human error.”What do you think about this finding? Have you ever heard any complaints from health officers (or yourself) on using EMR? Any suggestions to avoid or reduce this problem.
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2021-09-27 at 7:00 pm #31682Auswin RojanasumapongParticipant
I have heard about the complaints on using EMR and I sometimes experience myself. Using EMRs is good for storing health and decrease the chance of medical error (the physician prescribes the medication directly without writing it down on papers that have a chance to misinterpret due to poor handwriting). However, getting a patient’s medical history or doing a physical examination while typing it to the computer is often cumbersome. We were taught to talk with the patient without distraction, such as picking up the phone, looking at the wristwatch, or spend too much time with the computer screen. Doing so would lower the patient’s trust, decrease the doctor-patient relationship, which leads to poorer clinical outcomes.
To avoid this problem, the EMR system should be user-friendly and designed with the least clinical procedure distraction, such as changing the way the user input to the simplest form. For example, we are familiar with writing, so the system should base on writing and converting images of handwriting to text (e.g. OCR with advanced handwriting recognition), use voice recognition to input.
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2021-10-08 at 9:49 pm #32021Napisa Freya SawamiphakParticipant
Thank you for sharing. I agree that it may affect the patient relationship and the patient’s trust. Also, I like your suggestion about voice recognition!!!
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2021-09-30 at 6:59 pm #31757Arwin Jerome Manalo OndaParticipant
I don’t have experience using an EMR, nor I have heard from a colleague regarding the difficulty of using an EMR in the healthcare setting. However, based from the article, difficulty in integrating EMR to day-to-day tasks may be attributed to lack of proper trainings to its end-users. EMR aims to centralize the repository of medical records from various departments. Without proper training, one may feel alienated to using such and would find it cumbersome to use it – or worse, increase inefficiency on collating medical records in which the technology is supposedly doing. Burnout affects performance so as much as possible, tools are readily handed over to its users such that they can deliver the best health care as possible.
I agree on Auswin’s point to make EMRs more user-friendly; likewise, making it intuitive. Technologies are designed to make human tasks simpler. Applying AI on administrative tasks may take some huge financial investment, but may be worth it in the long run. There should be a transition period in embracing such technologies to ensure that errors are managed accordingly and won’t affect health delivery services.
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2021-10-01 at 6:05 am #31765SaranathKeymaster
I think EMR should be design to have some benefits to the users, such as some alert/warning, automated calculation. This may encourage the use of the system.
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2021-10-02 at 3:04 pm #31811Karina Dian LestariParticipant
I pretty much agree with Arwin’s opinion on the one cause of burnout. I imagine that health practitioners at the hospital are using paper-based medical record for so long, changing to electronic will takes a lot of time to get used to. In addition to proper training, a refreshment training (maybe once a year) is needed especially if the system had a big update. The developer also needs to take the health practitioners’ input on how the UI/UX should look like, because they are the one that mainly use it.
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2021-10-02 at 8:17 pm #31813TARO KITAParticipant
When I experienced and witnessed the introduction of EMR from a paper-based system in the hospital, I didn’t hear about the specific case of burnout, but many health personnel had difficulty adjusting themselves to the newly introduced system and some even decided to leave their jobs. As already mentioned by others, in addition to making the system more user-friendly, adequate training opportunities and follow-up support could have eased their burden carrying out their tasks.
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2021-10-03 at 8:45 pm #31835Tossapol PrapassaroParticipant
From my point of view, although EMR has many advantages for health informatics exchange, I agree that EMR might be one of the causes of the burnt-out of a physician, primarily when they are not used to typing or EMR interface is too complex. I heard many physicians complain that they have to spend more time or focus on using the EMR rather than listen to the patient’s symptoms. And there are still some aspects that EMR is hardly to replace paper-based such as drawing a finding from physical examination on EMR. I also agree with Auswin and others that to reduce this problem is to create an EMR that is user-friendly user, not too complex, and flexible enough.
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2021-10-04 at 3:05 am #31840Anawat ratchatornParticipant
I heard many complains about using EMR.
EMR used in my hospital was very useful and had every function needed. But there were some points that burden to providers.– Too many alert that made us has to click “Yes” too many times, for example, EMR alerted when we tried to order some investigation more than 1 time/day.
-> To solve this problem, we must design alert function to be more proper and more practical. I think that too sensitive level of alert function would make physician ignore it. EMR should pop up alert window only when necessary. The one who config or develop alert function should understand how healthcare providers work, so they can adjust level of alert function to proper level, not too much and not too less.– In my opinion, it’s not only about EMR, but also about our workflow that negatively affected our job. In a period of transition from paper-based to digital, that took a few years to be completed, we have to did many duplicate jobs.
-> Transformation from paper-based to digital should be planed properly. Duplicated tasks is major complain that make providers burnt-out. So we have to plan carefully about how should we transform and how long should it take. Another thing should be concerned is about our people who is not familiar to IT devices. There should be some training and support team to help them to use IT devices and EMR– In my hospital, there are many complains about slow response of EMR. It took around 50% of our time to wait for EMR to response in each click.
-> It depend on both EMR and hospital IT condition. I think that we should do a lot of research about both specification of the EMR ,including its technology and function, and about hospital IT resources including server spec, network, and also each computer’s spec. -
2021-10-05 at 8:26 am #31854Sri Budi FajariyanParticipant
EMR adds to the workload of doctors, but it is very important for documenting patient data and data communication between departments as well as for the benefit of public health so it needs to be simple and user-friendly. I once went to a hospital in the remote area where the recording of medical records was not yet electronic. Malaria data managers have to travel to many departments to record data on malaria patients. so that EMR, although it adds to the work of doctors, is very useful for recording data on public health programs
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2021-10-06 at 3:37 am #31876Navin PrasaiParticipant
The article highlighted the exhaustion and frustration of some healthcare workers working with electronic medical record systems and some ways to overcome it. It is undeniable that information technology changed a lot in all sectors including the health sector and it takes some time to cope with the new technologies. In my opinion, frequent training, the use of AI , reducing screen time will help to reduce this problem.
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2021-10-06 at 12:41 pm #31890chanapongParticipant
I have experienced some problems and also heard from other officers. EMR may increase workload and time for recording patient data, instead of only pay attention to the patients. But, EMR also increases data recording efficiency. Providing time to adapt when the transition from the paper-based medical record to EMR is crucial to the officers. Additionally, it should have a friendly GUI, reduced redundant data recording, proper notification or alert to avoid alert fatigue, and a system that supports the user to work more efficiently like OCR and voice recognition as Auswin suggested.
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2021-10-06 at 12:41 pm #31891Ashaya.iParticipant
In my opinion, electronic records support the medical services in many aspect such as provide the convenience to access and retrieve patient’s medical record, reduce the time to connect between each department of the hospital, reduce the cost to provide and maintain the storage of paper-based medical records and so on. At the same time, adoption new technology may cause some effect to users.
From my experiences, there is no clearly evidence about compliant on using EMR. However, I’ve been noticed that some doctor do not use EMR completely because some of them like to write down the doctor’s record and diagnosis on paper and that record need to scan and transfer to the computer system again. These may caused by many reasons such as they do not familiar with using EMR, or EMR has not user-friendly interfaces so they do not comfort to use it. Moreover, because of there are many section contained in EMR system to use in many department, it can makes some user get confused.
To avoid the problem, the organization should provide in instruction to use EMR effectively to user in each sector. Keep updating the knowledge about the medical record system to user is the way to reduce the user’s problem.
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2021-10-06 at 6:14 pm #31905Theekhathat HuapaiParticipant
Early adoption of any new technologies usually had difficulty in adaptation to a new way of working. As time progressed, early adoption, user and developer, became getting used to new technologies. New technologies usually optimize for the efficacy and efficiency of always complex medical care. And they cannot work in the old way again.
From my experience, I was studying in Maharat Nakhon Chiang Mai hospital, which is an early implementing EMR hospital in Thailand. When EMR was used in the beginning years, Personnel had trouble using EMR. As time pass by, EMR has an essential role in a hospital, from viewing patient history to booking a surgical room. An early example of clinical decision support is the drug error prevention system. A doctor does not require to find drug allergy history from the paper-based medical record. The program would give a warning if an allergy drug was prescribed.
To prevent any difficulty of transitioning to new technologies, Developer and user should design the program together. Well established protocol of the program should be made. Training a user is also important. The system must be easy to use and fix the problem regularly.
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2021-10-06 at 6:35 pm #31907Napisa Freya SawamiphakParticipant
I’ve heard complaints about using EMR while I was doing an internship in the hospital. Even though EMR is great for health informatics exchange, but it requires precise data intake and the workers need to be trained on it properly. Otherwise, it can create errors, for example, misdiagnosis. It may create an extra workload and burden to normal workflow during the early adoption period. Additionally, at my internship site, there were several EMR platforms that cover different parts of data and the platforms didn’t allow the data exchange to other platform completely. For example, the main EMR is used for all personal data but couldn’t see the trend/analysis of drug used, so the worker needs to switch to another EMR platform. This can create confusion and spend extra time on finding data/training to use all EMR platforms.
To avoid the problem, the EMR should be user-friendly, requires less time, and use only the main EMR/system if possible.
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2021-10-07 at 11:40 am #31946SaranathKeymaster
Thanks everyone for sharing your thought! It is undeniable that the EMR is beneficial in healthcare and health practice. However, the EMR should have user friendly UX/UI. The transition phase should be well prepared. Alerts/warnings messages should be appropriately designed. Training and supporting system should be provided.
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2021-10-08 at 1:08 pm #31999Hazem AbouelfetouhParticipant
In my opinion, Before implementing a new EHR system, Clinicians should evaluate EHR and provide feedback to Health IT to evaluate the feasibility of the changes and what could be improved or customized in the User Interface.
I believe this issue will be decreased over time because many EMR providers working on improving UI/UX interface. Also, It is easier for the new generation of clinicians to deal with computer software including EMR.
In the meantime, Health care providers should invest more in EHR training.
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2021-10-13 at 7:11 pm #32083Auswin RojanasumapongParticipant
I agree with you about clinicians evaluating the system before implementing it in the real workplace setting. It is good for both the clinicians to prepare for the newer system, while the developer can correct the details of the system to suits the need of clinicians.
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2021-10-11 at 4:20 pm #32061Pimthong SinchaiParticipant
For my experience, I don’t have directly experience with EMR. Only be a patient that give the information to the system. Anyway, I still have heard about collected information system among local hospital near my home. Some of them still use traditional way to collect the patient’s data such as book and notebook. the big problem of the hospital is some staff can not understand the technology, its complicated and hard to understand. So, I agree with other that the EMR is a good system that serve all healthcare system but to improve this, it should be more easily to use and more simply in term of real-using. I think Should provide some program or activity that improve skill of healthcare staff too.
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2021-10-17 at 4:53 pm #32225Weerada TrongtranonthParticipant
I experienced using EMR. There were lots of problems about duplicated work with paper. Since That wasn’t totally paper-less led to incomplete records. And some EMRs designed quite confused, User-friendly EMRs is so important to make them easy to use.
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