- This topic has 24 replies, 14 voices, and was last updated 3 years, 7 months ago by Kridsada Sirichaisit.
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2020-09-24 at 8:44 pm #22741SaranathKeymaster
You have learned the benefit of Health Information Exchange. The Electronic Medical Record (EMR) is one of basic structure in order to exchange information among different departments/organizations.
Recently, there are many reports stating that EMR is one of top leading cause of physician burnout. Here is an example: https://medcitynews.com/2019/03/physician-burnout-ehr-satisfaction/. EMR/EHR are the second-leading contributor to physician burnout, according to a survey of 6,849 physicians in the US.
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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2020-10-02 at 12:09 am #22907Pongsakorn SadakornParticipant
From my experience, I work at the central organization so I am not familiar with the physician or staff in the hospital, but I heard many doctors and physician said that time-consuming is the main issue for EMR because after the patient visit the doctor, the doctor will fill the data of the patient to the program in the computer which takes time to fill the various parameter. In addition, for the doctors who work more than one hospital, they need to remember the hospital system and information system in each hospital, this is cause to chaos in some time. However, I think that the possible way to reduce this problem is the involvement of stakeholders especially physicians to design an appropriate system environment to avoid burnout.
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2020-10-02 at 11:29 pm #22933Sila KlanklaeoParticipant
I heard many nurses talk about their workload to recording data patients. Because the doctor did not record all the information.
Designing of Screen for Medical Record Keep it simple and uncomplicated It helps to reduce the problems of doctors and nurses in recording patient information. -
2020-10-03 at 10:16 pm #22978Ornpicha ThiampolParticipant
According to the news, I found that the physician spends a lot of time using the EHR system for documentation, ordering tests, reviewing results, and communicating with patients or other physicians. So, this can cause burnout. I heard some of them complain when they need to fill the data in the system. I think the best way to solve this problem is a straightforward design for an EHR system. The vendors should develop software that allows physicians to quickly see the patient’s most relevant medical, health, and social history. There should have a function that types automatically after the voice, so it is easier for the physicians. Furthermore, The excellent design EHR will help the physician to enter only the necessary information.
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2020-10-07 at 3:24 am #23079Khaing Zin Zin HtweParticipant
Voice-typing is one good solution. Thanks for pointing out.
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2020-10-04 at 1:44 am #22981Wachirawit SupasaParticipant
I think the reasons that make many physicians detested the EHR system because they haven’t trained to use this system in the school and they need to adapt to it instead of using patient charts, pen, and paper and we cannot blame it only on physician too, the good EHR must be built to suit medical personnel as high as possible. By designing an intuitive EHR system for medical personnel could help reduce burn out rate.
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2020-10-07 at 3:24 am #23078Khaing Zin Zin HtweParticipant
Agree with you on integrating EHR in medical and related universities.
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2020-10-21 at 12:18 am #23446Kridsada SirichaisitParticipant
I agree with you. EHR system design that convenient to use is the success factor for physician use the system.
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2020-10-05 at 11:57 pm #23011Saravalee SuphakarnParticipant
– Following the article, one of physician’s complaints about EMR is time. Some of them said that they must take four times as long to complete EMR compare to writing it down. Moreover, not just spend time in working hours, a lot of doctors have to spend personal time or family time to complete EMR. I think that is one factors cause physician burn out from EMR.
– For me, It’s true that I never heard about this topic before because I work in veterinary field, less opportunities to recognized the problem in healthcare practices field. Although, I have friends who work in this field, they didn’t tell about the problem.
– The burnout problem is multifactor that related. To reduce or avoid the problem, should understand all around factors. If focus on cause form only EMR, the developer or provider or vendor EMR should developed it to easier to use in real practice field and reduce redundancy of the program to reduce the time that physicians must spend.
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2020-10-08 at 4:49 am #23188SaranathKeymaster
Probably, one reason that Thai doctors do not complain about this issue is that EMR in most hospitals in Thailand is not a full EMR. Many hospitals still let doctors write in a paper, then scan it to the hospital information system (with enforce doctors to put only diagnosis and treatment in the system). Or some hospitals assigned nurses to fill out the info to the HIS, instead of doctors – as Sila’s comments that he heard complaints form nurses.
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2020-10-05 at 11:59 pm #23012Saravalee SuphakarnParticipant
I agree with you all that design of program is important factor to reduce the burnout problem from EMR.
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2020-10-06 at 7:29 pm #23060NaphatParticipant
I think it’s a system that increases the workload for doctors, nurses and public health staffs. But it cannot be denied that it is a system that drives Thai public health. Just may have to modify the recording format and scope information to be simple, easy and convinient to entry all information by medical staffs
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2020-10-06 at 7:38 pm #23061Kridsada SirichaisitParticipant
This finding is true. EMR is the pain point among treatment period. Clinical reasoning between patient treatment period was interrupt with unfriendly UI of HIS. The period that most effective to use EMR is OPD period because I use HIS as OPD care review and record, this is usual practice. But in IPD period I must round bed by bed HIS is not practical for use at that time.
The EMR system that can help these problem in IPD period must be
1. Available access via tablet that like IPD Chart.
2. I can command via voice, or record by voice, It’ very perfect.
3. EMR can view every document in hospital such as, EMR, PACS, EKG, LAB.
4. Can use hand writing like pen to record.-
2020-10-07 at 3:40 am #23081Khaing Zin Zin HtweParticipant
Access from tablet might be more accepted by clinicians since it is portable and easier to use due to its screen touch feature.
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2020-10-12 at 2:03 am #23283Ornpicha ThiampolParticipant
I think so. Voice command and tablets are good ways to solve this problem but not every physician can do this. They need training first before change the system.
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2020-10-07 at 3:38 am #23080Khaing Zin Zin HtweParticipant
This report gave me an insight into another perspective on EHR. Although the correlation as shown in the scatterplot is low, the survey indicates a lot of physicians having burnout from EHR. The complicated relationship between physician burnout and EHR should be established with further studies/research.
Although I have never heard of any physician complaining about EHR in my experience, I think the following measures might help solve the problem:
– integrating EHR and basic IT courses in medical and related schools so that familiarity of healthcare professionals with EHR becomes the highest
– involvement of clinicians in the development of EHRs
– prioritizing user-friendliness in the development
– adding features like scanning hand-written notes, voice-typing. -
2020-10-07 at 2:09 pm #23183Sittidech SurasriParticipant
Totally agree with your comment that the complicated relationship between physician burnout and EHR should be established with further studies/research.
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2020-10-07 at 3:03 pm #23184Sittidech SurasriParticipant
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.
From the article, I think that the finding is true (one example from the article that from Taylor Davis, EVP of analysis and strategy was reported that the Clinicians report that EHRs are [a] top contributor to burnout, but when we look at organizational averages for burnout rates vs. organizational averages for EHR satisfaction, the correlation is low,” , He noted that while the EHR is frequently a problem for providers, fixing it won’t solve all burnout, as burnout is a multifaceted issue.)
To me, I never have experiences about EHR but I observed that When I went to see the doctor, many hospitals have adopted technology in recording and/or providing services, for example, I went to see a doctor and doctor can checked/reviewed my medical history via computer, and recorded the diagnosis and treatment through a computer system. This was noticed that, the doctor was not good in using computers (typing issue)-that due to the doctor may be very old (> 70 yrs). Therefore, I think that adopting the EHR system, designing the EHR system, the training and the implementation should be considered and it would help to reduce this problem.
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2020-10-08 at 4:57 am #23189SaranathKeymaster
Many of you suggest to let doctors involve in the EMR development process. Please keep in mind that you should carefully select the doctors to get involved. Ask doctors that are likely to accept to a new change, those who know the needs of having EMR. Once the system implemented, these doctors will be persons who encourage the EMR used for others. Anyway, this issue is about change management that you will learn in Week 5!
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2020-10-08 at 10:19 pm #23203Rawinan SomaParticipant
I used to work at district hospital that use fully EMR before. I encounter some problems like program did not allow me to prescribe some drug but unclear reason, program crashed sometimes, and patients complain that physician did not pay attention to them. During FETP training, I explored the EMR systems in the hospital. I found the most issue from user was the redundancy. They had to entry the data too many times in the different systems. Another problem is how to communicate or give feedback the problems to the developer and executive level. To minimize these problems, we need to start from the designing phase, getting all requirement from all stakeholders as much as possible. The good information system will cause benefits more than chaos.
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2020-10-11 at 8:41 am #23244Navinee KruahongParticipant
What do you think about this finding?
Burnout, a state of mental exhaustion resulting from chronic stress in the working situation. Burnout is commonly regarded as a syndrome comprising three dimensions; emotional exhaustion, depersonalisation (refers to a cynical, negative attitude towards one’s work or towards the recipients of one’s service), and reduced personal accomplishment. I think it might be useful, if they state how they define “Burnout” and what dimension they included in their studies? Moreover, existing studies show that the causes of burnout come from various factors such as workload, perceived lack of control, reward, community, fairness, and values mismatch. Which I think different work places might come up with different causes of burnout. If they only focused on the satisfaction of health workers on EMR, I would not buy it yet.Have you ever heard any complaints from health officers (or yourself) on using EMR?
Yes, I have! from the primary healthcare stuffs who have to deal it many many KPIs of MOPH. They are the important one who entry the grounded data to our Ministry. Only word they said to me is “exhausted!” (I’m not sure in my case is included as an EMR)Any suggestions to avoid or reduce this problem.
This problem is not just about changing tools and the way their work. but it is also about changing traditional culture of healthcare system which take time and require participation of all health worker levels.
Moreover, there are barriers such as a lack of human resources, lack of awareness and unfamiliarity with the potential benefits of using EMR in healthcare. I recommend the following points which could help to overcome these barriers:
• Leadership of healthcare should establish vision and clear essential tasks of digital transformation which all health workers can hold the shared values of their jobs. (Why and How we doing this?)
• Incentives and mandates are important to the adoption of EMR.
• Advocacy on the potential benefits.
– Capacity building is also important, human resources need to be extented.-
2020-10-11 at 2:20 pm #23251Kaung Khant TinParticipant
Yes, I agree with your suggestions. I think technology barrier to the EMRs is no longer a case as everyone is literally using mobile devices and so they are not that strange to the IT. The key barrier is the reluctance to the change which can be solved by leadership, incentives and advocacy.
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2020-10-11 at 2:14 pm #23250Kaung Khant TinParticipant
What do you think about this finding?
Honestly speaking, this article surprised me a little bit. Before that, I’ve thought that the implementation of the EMR to the clinical setting would make a faster and easier recording system for the clinicians so that the clinicians are satisfied with the results. This article presented a different approach to the use of EMR in the health sector. Anyway, though Arch Collaborative Study said EHR is the 2nd leading contributor to the burnout of clinicians, the correlation coefficient between burnout and HER net experience score is -0.07 which is very little or low. Even though the study from Notre Dame university examined that the tie between EHRs and physicians leaving the medical field, it could not approve any evidence of retirements as a result of HER implementation. And the other quantitative and qualitative studies could not illustrate the clear-cut relationship between EHR and the burnout. So, I think we need more systematic review or new original research studies on this topic to clearly identify the relationship.Have you ever heard any complaints from health officers (or yourself) on using EMR?
Regarding using EMR, I’ve experienced complaints from health officers. Anyway, if I closely inspect those complaints and conditions, I think that people natural resistance to change process, double data entry to both paper and EMR, and technical problems are the key factors.Any suggestions to avoid or reduce this problem.
Now, the information technology devices are much more advanced and user-friendly than ever. Portable laptops, tablets, iPads and pencils have made the EMR users to record the medical data more efficiently and effectively. The EMR software and applications become much more comprehensible and straightforward with the insights and feedbacks from the medical doctors and other users. The guidelines and procedures from central government are being adopted for a better engagement of EMR system to the health sector. All these favors the successful revolution of EMRs in the health sector. -
2020-10-11 at 11:32 pm #23263Phone Suu KhaingParticipant
What do you think about this finding?
This is really an interesting finding for me that clinicians reporting EHR is the top contributor to burnout.
Have you ever heard any complaints from health officers (or yourself) on using EMR?
Yes. I encountered it when I went to a private hospital. The clinician has to fill patient’s data while consulting the patient. I heard them saying that this is double burden for them and not comfortable.
Any suggestions to avoid or reduce this problem.
1. By providing User friendly features with advanced software
2. Communication with users
3. Feedback Response Mechanism among users, IT technicians and leaders for change
4. Strong leadership
5. Capacity building -
2020-10-11 at 11:36 pm #23264Phone Suu KhaingParticipant
EMR system with voice command is very challenging yet highly benefit!
Thanks for pointing this out!
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