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Thriving in an EHR 2.0 World
By Thomas J. Bryant, ARM
President, Physicians Insurance
Five years ago, if you started talking about electronic health record (EHR) systems in a roomful of physicians, you would have predictably gotten groans — not to mention some bitter, and yes, often justified, complaints.
EHR systems used to be everyone’s number one villain — the sworn enemy of physicians and practice managers — and they were routinely blamed as a major factor in frustration, professional burnout, and medical errors.
Physicians and administrators were told to be patient, and that things would get better. Eventually, more software improvements and usability training would allow EHR systems to begin to fulfill their promise: transforming medicine by improving care, reducing costs, and serving, rather than antagonizing, caregivers.
But it has been a slow climb. EHR systems continue to play a major role in practice risk and medical injury lawsuits. The October 2020 A Call For Action report from Coverys found the majority (59%) of EHR events were tied to medium-to-low severity injuries.
However, the EHR-related payouts can be considerable: the report showed more than half of the total indemnity dollars paid out were attributed to 30.6% of EHR events that resulted in death.
Emerging Risk:
Documentation continues to be the most common risk management subcategory for EHR systems, making up 72% of all EHR-related risk issues. According to the report, other prevalent risk areas included system issues such as “confusing system design and incorrect patient information due to a system conversion and general EHR usability.”
But the EHR improvement journey continues more slowly than most physicians wish, according to a study published in the Journal of Clinical Informatics. A poll of more than 72,000 clinicians at more than 150 hospitals and health systems nationwide found that “critical gaps” remain in users’ understanding of how to optimize their EHR.
Next Steps:
According to researchers interviewed for the study “We as an industry have an opportunity to improve EHR adoption by investing in EHR learning and personalization support for caregivers… If health care organizations offered higher-quality educational opportunities for their care providers — and if providers were expected to develop greater mastery of EHR functionality — many of the current EHR challenges would be ameliorated.”
The American Medical Association is taking the next step — EHR v2.0 — with its new Practice Transformation Initiative, designed to help physicians fill knowledge gaps and achieve evidence-based best practices.
A particular focus of the AMA will be on the personalization of workflow improvement tools and sharing best practices within an AMA-facilitated learning community.
Meanwhile, according to Healthcare IT News, leaders from the major EHR systems, Cerner and Epic, made public commitments at the Healthcare Information Management Systems Society 2019 convention to recommit themselves to the physician-user experience, with AI technology as a game-changer in the process.
This is promising, but it appears we will have to wait a bit longer for the potential of EHR systems to transform practice workflow and physician liability. We will be sure to update clients and our health care community as we see new risks evolve.
Physicians Insurance President Thomas J. Bryant, ARM, is a licensed property, casualty, life, accident, and health broker in all six New England states and was an adjunct clinical assistant professor in the School of Health Sciences at Bryant University during the period from 2016 through 2018. Most recently Tom developed a video presentation on malpractice basics for Harvard Medical School fourth-year students, and he has participated in NEJM Resident 360 virtual panels on topics related to financial matters important to early-career physicians.
Is it time to examine your current policy? What you don’t know can hurt you. For more information on how Physicians Insurance can support your practice and help you mitigate risk, call 800.522.7426.
Please email Meghan Stanley at mstanley@mms.org with any concerns you would like to see us cover in this space.
posted May 4, 2021
