The rapid advancement of technology in healthcare has led to the widespread adoption of Electronic Health Records (EHRs) across medical facilities in the United States. Although these systems aim to improve efficiency and patient care, challenges in poorly designed EHR systems can impede their intended benefits, impacting patient safety and clinical workflows. Medical practice administrators, owners, and IT managers must understand these challenges and consider solutions that improve usability and safety of these systems within their organizations.
Research has indicated that for every eight hours spent with patients, office-based physicians dedicate more than five hours to managing EHR tasks. This disproportionate time allocation creates a situation where clinicians face increased clerical workloads, leading to burnout and disengagement from patient care. A 2018 report from the American Medical Association (AMA) identified seven critical usability and safety challenges associated with EHR systems:
Christine Sinsky, MD, a leader in physician satisfaction research, emphasizes that burdensome EHR systems significantly contribute to the physician burnout crisis. This highlights the need for health systems to re-evaluate how technology integrates into clinical workflows.
The implications of poor EHR design extend beyond inconveniences; they pose serious threats to patient safety. Studies have shown that medication errors commonly occur during ordering or prescribing stages, with incorrect dosages being particularly prevalent. A study revealed that technological issues, including problems with EHR alerts, were responsible for 20% of duplicate medication orders. These duplicate orders complicate patient management and increase the likelihood of adverse drug events.
Furthermore, a significant challenge known as “alert fatigue” emerges from EHR design flaws. As clinicians receive excessive alerts—many of which are irrelevant or redundant—they become desensitized. A report indicated that approximately 44.8% of drug allergy alerts are overridden, which raises concerns regarding the potential for missed critical interventions. When alert systems generate numerous unnecessary warnings, clinicians may begin to ignore them, unintentionally putting patient safety at risk.
One of the core issues contributing to the challenges of EHR systems is how well these technological solutions align with existing clinical workflows. Poorly designed EHR systems do not consider realistic workplace scenarios, leading to a cumbersome experience for healthcare professionals. Clinicians may find themselves employing workarounds to complete tasks more efficiently, thus introducing even greater risks for errors.
For example, a clinician may skip important notifications due to workflow interruptions caused by the EHR’s confusing navigation. Such disruptions can lead to critical information being missed or the wrong decisions being made based on incomplete data. As a result, patient care can suffer, and the likelihood of medical errors increases.
The integration of artificial intelligence (AI) and workflow automation can provide several solutions to the challenges posed by poorly designed EHR systems. When implemented effectively, these technologies can streamline processes, reduce the clerical burden on healthcare providers, and enhance patient safety.
AI can automate routine tasks such as data entry, prescription refills, and appointment scheduling. By reducing the amount of manual input required from clinicians, healthcare organizations can alleviate some of the administrative burden affecting providers. AI systems can learn and adapt to clinician preferences, improving efficiency and reducing time spent on EHR-related tasks.
Integrating AI into EHR systems can enhance Clinical Decision Support (CDS) tools. These tools can analyze patient data in real-time, alerting clinicians to potential issues such as drug interactions or the need for preventative care. By improving the specificity of alerts, AI-driven systems can reduce alert fatigue, ensuring that clinicians are notified only about significant concerns requiring their attention.
AI can facilitate better interoperability between different EHR systems. By creating standards for data exchange, AI technologies can enable seamless communication of vital patient information across various platforms. This is important for ensuring that clinicians have access to a complete picture of a patient’s medical history, allowing for more informed decision-making.
The integration of AI can lead to customized workflows tailored to the specific needs and habits of clinicians within a practice. By studying how clinicians interact with the EHR, AI systems can identify bottlenecks and provide insights to improve usability. This can result in a more intuitive design that aligns better with the clinical environment, making it easier for healthcare providers to navigate the system effectively.
Despite advances in technology, ongoing challenges persist regarding EHR usability and patient safety. Poorly designed EHRs do not seamlessly fit into existing clinical practices, often causing clinicians to work outside the intended functionality of the system. This disconnect increases the risk of medical errors and places a greater burden on healthcare professionals.
The Centers for Medicare & Medicaid Services (CMS) emphasizes the importance of using the SAFER guides, which support organizations in assessing the safety of their EHR systems. These guides encourage organizations to adopt effective practices that enhance patient safety while reducing risks associated with poorly designed systems.
Moreover, research continues to highlight the significance of physician input into customization processes. Involving clinicians in the design and implementation of EHR systems helps ensure that the tools provided align with the workflows and needs of staff. This collaborative approach can improve usability and help identify potential safety issues before impacting patient care.
A well-implemented CDS tool can enhance patient safety by providing clinicians with relevant, patient-specific information at the point of care. However, for CDS systems to be effective, they must be carefully designed to avoid adding unnecessary complexity to the clinician’s workflow.
Research shows that when CDS tools are integrated effectively into EHR systems, they can reduce prescribing errors. For instance, one study noted a 78% increase in successful medication discontinuations following the implementation of deprescribing software. These improvements illustrate how thoughtful technology integration can lead to better health outcomes.
However, ongoing challenges, such as alert fatigue and high override rates, persist in the use of CDS tools. As medical practices seek to optimize patient care, they must continue refining alert and decision support structures to minimize clinician frustration and ensure critical notifications are noticed.
Poorly designed EHR systems represent a barrier to improving patient safety and clinical workflows within healthcare organizations in the United States. As medical practice administrators, owners, and IT managers manage these challenges, they must prioritize strategies that incorporate user-centered design, effective decision support, and the integration of advanced technologies like AI. By addressing the usability and safety issues in EHR systems, healthcare providers can improve the quality of care and create a more efficient clinical environment.
Simbo is making doctors' and patients' lives better. Connect now to know more.
Schedule Demo Now© Since 2019, Simbo AI.
