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A response to Why Doctors Hate Their Computers

When physicians read Dr. Atul Gawande’s article in The New Yorker, “Why Doctors Hate Their Computers,” they will undoubtedly recognize many of the health IT challenges he identified. Examples such as unwieldy problem lists or ”note bloat” are unintended consequences of the technologies intended to help us.

Dr. Gawande writes at length about how electronic health records (EHRs) and the process of digitizing healthcare have overburdened today’s physicians, driving a wedge between them and their patients. While I agree that EHRs play an important role in addressing clinician burnout, health IT is a shared responsibility and only a broader, systems-level approach will begin to improve the clinician experience.

It’s not just the EHR

Healthcare is a complex, adaptive system. As such, problems related to clinician burnout are multi-factorial and require us to look at the big picture to effect real change. The National Academy of Medicine offers a conceptual model of the seven interrelated domains that contribute to clinician well-being and resilience:

Image credit: National Academy of Medicine. Original Source

These factors also affect the effectiveness of EHRs. For example, regulatory, business and payer environments require that EHRs facilitate more documentation than ever before. Organizational policies determine how EHRs are deployed and supported. Healthcare roles need clear alignment of responsibility and authority, which must be accurately reflected in EHRs.

With this perspective on the interrelated influences that affect healthcare, it would be short-sighted to assume that a better EHR is all we need. Yes, we must continue to improve health IT. But innovation doesn’t have to be just technological; it can be a new process, policy or approach. We should be innovative in every area.

What is keeping physicians up at night

When I talk to physician colleagues, friends and family – including my wife, who works long hours to keep up with her busy practice – I hear familiar themes. They understand concerns about the technology, but those are the least of their worries.

Instead, physicians are concerned for patients with increasingly complex healthcare needs. They are staying up late and getting up early to keep up with the administrative tasks that pile up during a typical work day. They are frustrated when these tasks keep them from working at the top of their license. They are balancing competing priorities of achieving safe, high-quality care, engaging patients and meeting productivity and reimbursement requirements.

Many physicians have reached a breaking point, and it’s up to everyone in the industry to do their part to relieve clinician burdens.

Our commitment at Allscripts

Allscripts is committed to reducing clinician burnout and doing so in collaboration with other industry stakeholders. We’re focused on best practices in user-centered design, and we’re going beyond usability to create solutions that are more helpful to clinicians.

We realize that it’s a team effort, and that we should facilitate innovation – even if it doesn’t come from one of our developers. Since 2007, Allscripts has had an open platform and application programming interfaces (APIs), which enable healthcare providers to incorporate the third-party innovations that matter most to them. This interoperable ecosystem has facilitated more than 4 billion data shares since 2013, and that number continues to grow.

Improving health IT continues to be a shared responsibility. Every stakeholder must use its influence and expertise to enhance – not hinder – the patient-provider relationship.

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