The challenge of data entry in EHRs

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It’s no secret that the amount of time health providers spend registering data on their computers is incredibly high. Recent studies showed that primary care physicians spend almost six hours on Electronic Health Records (EHR) data entry during their typical 11.4-hour workday. The recent pandemic of physician burnout is caused, mainly, by the disproportionate time allocation of EHR tasks to medical professionals.

One of the most troubling problems when talking about data entry in the physician’s workflows are the called “hard stops”. This pauses in doctor-patient interaction are caused by the need to spend time documenting the visit using a computer. Using a keyboard to write the clinical notes requires the user to focus on a computer screen for an amount of time directly proportional to the length and desired level of detail of the notes. Sometimes, the patients will interrupt the physician: they are usually nervous, and the awkward silence while typing documentation probably is an invitation to fill the void with questions. Trying to make this hard-stop quick, physicians are forced to synthesize and this can cause a decrement of quality in clinical documentation.

The tech world has not being blind or deaf on this subject. Several companies have dedicated a lot of time and effort developing state-of-the-art pieces of software that focus on recording all activity during a medical visit, to allow physicians to spend less time in front of their computers and more time facing their patients. Most of these solutions rely on voice recognition and natural language processing, transcribing all doctor and patient interactions to text, and possibly interacting directly with their EHR. This approach has a double benefit: freeing physicians from the slavery of the computer to let them take care of their real work, and also for the patient, who now can hear everything that will go to their medical record, no mysteries, no secrets.

The problems with their approach: even if they allow the patient to listen to the physician dictations, they recall very little of it when they get back home. Also, because physicians trust that these systems are listening to the whole interaction, they start trusting the A.I. to synthesize, which is one of the most important qualities of their profession. Keep in mind that these solutions are really expensive, and require the hospital or clinic to invest huge amounts of time and money to deploy these technologies on the workplace. Also, they rely on an EHR to work with. At Sherplay we believe this kind of technology should:

  • Allow the physicians to decide when and what to document. Record only the important stuff.
  • Be easily accessible to every physician everywhere, completely free and working as a tool, independent of the EHR but able to migrate data there if needed.
  • Even if you are on a campaign hospital, with no computers, you can have all your cases and clinical notes in your phone, sharing them with your team in the field.
  • You only need a smartphone.
  • Allow physicians to share all notes with their patients and/or their relatives.

Even when having a virtual scribe transcribing every note in your phone is a great idea for most physicians, the open notes trigger diverse response in some. The use of EHRs have created in the last decades, an almost unspoken rule between physicians: “Not everything we write in our clinical notes should or could be shared with our patients”. When consulted about this, most healthcare professionals argue that sharing everything with patients could:

  • Scare them
  • Confuse them
  • Put the physicians in legal trouble later

In 2010, as part of the OpenNotes initiative, 105 physicians and 20.000 of their patients completed a multicentric study of open clinical notes during a whole year. As part of this project, primary attention doctors invited all their patients to read their clinical notes. The results were astounding;

  • 4 of 5 patients manifest interest in reading their notes when given a chance
  • They have a better understanding of your health and medical condition
  • They remember the treatment plan more accurately
  • Feel more in control of their treatment
  • Take better care of themselves;
  • They have a better and stronger relationship with their doctors
  • Patient satisfaction ratings improve significantly
  • None of the patients used the notes for any legal action

Can a free app offer physicians the double benefit of reducing the down-time of typing clinical notes in an organized way and also allow them to become pioneers on a global movement for doctor-patient transparency? Yes, we think so.

We think this is the right time to offer healthcare professionals the tool they need to differentiate them from the rest, outperforming at work and developing a stronger relationship with their patients, empowering them to be more involved with their health.

Data entry at hospitals and clinics must change, GLOBALLY.

It’s the time. Time for Beeseet

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