92 Percent of Nurses Dissatisfied with Electronic Health Records
Although we have frequently discussed physicians’ dissatisfaction with electronic health records, doctors are not the only victims of the federal government’s $30 billion adventure in underwriting poor IT investments. Nurses are even more disappointed in EHRs than doctors are, according to a new survey by Black Book Market Research:
Dissatisfaction with inpatient electronic health record systems among nurses has escalated to an all-time high of 92%, according to the Q3 2014 Black Book EHR Loyalty survey results to be published later this month. Disruption in productivity and workflow has also negatively influenced job dissatisfaction according to nurses in 84% of U.S. hospitals. 85% of nurses state they are struggling with continually flawed EHR systems and 88% blame financial administrators and CIOs for selecting low performance systems based on EHR pricing, government incentives and cutting corners at the expense of quality of care. 84% of nursing administrators in not-for-profit hospitals, and 97% of nursing administrators in for-profit hospitals confirm that the impact on nurses’ workloads including the efficient flow of direct patient care duties were not considered highly enough in their administration’s final EHR selection decision.
Allow me to point out that even nurses working on the front lines of health care, who should be too busy taking care of patients to concern themselves with the goings on of politicians and bureaucrats, are aware that “government incentives” are a major cause of the problems that they face dealing with EHRs every day.
The federal financing of bad investment in EHRs is coming to an end. Soon, hospitals and physicians’ offices will be “ripping and replacing” the EHRs that the government bribed them to implement. As long as the government does not insert itself into the process again, the next generation of EHRs will be implemented based on patients’ needs instead of government’s priorities.
Have high-skilled workers ever faced this amount of inconvenience in the name of convenience?
all the time. nurses use the EHR for data entry, writing in a file at the foot of the bed is much easier, an EHR can not compete. But using the data after entry, an EHR wins very easily. Go to the lab in the hospital, you will find them using an LIS or LIMS, would it be easier for the techs to use paper, no doubt. Would it be easier for doctors to use the results? Data entry is necessary process for these types of systems, it is not their purpose.
If you had asked anyone who has any experience with managing these types of systems, they could have told this way ahead time, instead there were moron politicians pretending to be IT managers saying how great this would be. That is the problem.
That’s pretty bad.
How long have these new technologies been used? It is unsurprising that people dislike new technology. There is always complaining, and people get used to the new system.
Your points are valid, but complaint at such high rates?
Perhaps Nurses reasonably believe that any slow down in their productivity could harm patients. However, the systems will need to be upgraded at some point. You can growing pains now or growing pains later.
I bet these system are probably very expensive initially, but might they not save money in the long-run?
Dear John and friends:
The nurses are right. When I was in the hospital in August, it was vividly apparent that the nurses had to look into the monitor rather than at the patient, had to re-enter data that AI knew was already in the system, had to ask me to correct information that was already obsolete, such as my meds, and could not print out a copy to give to me, even through I had just had a fairly serious surgery, and had 5 other co-morbidities. The monitors and keyboards are not the modern ones where a finger swipe can bring up what you want to see. In fact, 565% of the systems are by EPID, which was developed in a much earlier era when FFS payment methods predominated. Epic is just now getting to the point that it can integrate with the financial system–in one place.
I predict a real backlash when the new ICD-10 codes has to be built into the operating system–it is a 100 times more complicated than it needs to be. I spent 4 years on the Board of the former Commission on Professional and Hospital activities, so I’m familiar with disease coding.
Politically, voters and analysts should know that EPIC’s founder and president was involved in specifying what EHRs should be rewquired by the PPACA, and contributed mucho money to the President’s campaign. You get what you pay for.
Wanda Jones
San Francisco
I back up Wanda’s account. Took my son in to see pediatrician and the septuagenarian spent more time looking at the monitor and hunting and pecking the keyboard vs actually being a diagnostician and treating my son. That will be made slower when the 68,000 ICD 10 codes are released in 10/2015. Imagine that same doctor will have to memorize a whole host of new codes. BTW there are only 13,000 ICD9 codes so there’s gonna be a 5 fold increase in diagnostic specificity that doctors and nurses will have to learn. I assume my sons doctor will probably retire instead of learning all the new codes. A 2008 study reported that the new codes will cost Doctors offices $50-$200k to update their offices. That cost plus the cost of the new EMR systems in addition to reimbursement reductions in Medicare and Mediciaid will force doctors in quite a bind in the near future.
Perhaps it will reduce the quality of diagnoses, because physicians will choose only a few of the top codes to use.
The government likes its healthcare IT cottage industry too much and seems to have no intention of specifying a universal IT platform that would allow for seamless communication within healthcare. How crazy that technology has so seamlessly computed automated every part of our lives with off the charts user friendliness and consumer satisfaction while the one industry that impacts so much–government, health insurance companies, medical suppliers, medical accounting, medical research, healthcare providers and patients– suffers from inadequate and cumbersome IT. It’s a crime.
Anything that slows the work flow is going to be disliked. Nurses disliked “charging” back when it was done on paper records. They still don’t like it now that it’s done on a computer screen. That said, the interface for EHR may not be designed to complement the way nurses actually work.
Hi everyone – very interesting article and comments. I’m across the pond working in the NHS. My organisation is in the early stages of upgrading to EHR from a number of old systems that are soon to become obsolete. At the moment, it looks like we’re going with EPIC. We have practically no experience of paperless working.
What do you think we should be looking out for?
Look out for government-hired consultants giving you the “solution”!