Survey: EHR Use Affects Physician Professional Satisfaction

The usability of an electronic health records system can have a major impact on physician professional satisfaction, according to a recent survey report by Rand Health, a division of Rand Corp.

The not-for-profit research and analysis firm conducted the survey from January to August of 2013 by interviewing 220 physicians and other leaders of 30 group practices of varying sizes across six states. Its report, “Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy,” was sponsored by the American Medical Association.

The study found that physicians reported higher levels of professional satisfaction when they believed they were providing high levels of care. And EHRs played a big factor in those satisfaction levels—both positive and negative.

For example, some physicians said EHRs helped them remotely access patient information and improve care quality. These respondents also saw cited additional potential as well.

“Physicians, practice leaders, and other staff also noted the potential of EHRs to further improve both patient care and professional satisfaction in the future, as EHR technology—especially user interfaces and health information exchange—improves,” according to the report.

But other physicians, however, indicated that EHRs worsened their professional satisfaction. They described the technology as time-consuming, inefficient, less fulfilling and generally difficult to use. They also cited the inability to use EHRs to exchange health information among other data systems and the degradation of clinical documentation by the technology as a prominent source of their professional dissatisfaction.

“The current state of EHR technology appears to significantly worsen professional satisfaction for many physicians—sometimes in ways that raise concerns about effects on patient care,” according to the report. “Until EHR usability improves dramatically, to the point that directly interacting with an EHR neither creates additional, excessive clerical work for physicians nor distracts from patient care, removing regulatory and legal barriers to using other practice staff to interact directly with EHRs will allow physicians more time to perform work that requires physician training.”

While some practices reported that problems with EHRs were common among their senior physicians, others said they were taking steps to address these causes of physician dissatisfaction with the technology. Such steps included enabling physicians to have multiple modes of data entry, such as via scribes or dictation and a human transcriptionist, or to employ other staff to help ensure physician interaction with EHRs was limited to only clinical work.

Other factors that affect physician satisfaction also include work quantity, content and practice finances—as well as regulatory concerns, such as meaningful use and healthcare reform, according to the report.