Do electronic health record systems "dumb down" clinicians?

Genevieve B Melton; James J Cimino; Christoph U Lehmann; Patricia R Sengstack; Joshua C Smith; William M Tierney; Randolph A Miller

doi:10.1093/jamia/ocac163

Do electronic health record systems "dumb down" clinicians?

J Am Med Inform Assoc. 2022 Dec 13;30(1):172-177. doi: 10.1093/jamia/ocac163.

Authors

Genevieve B Melton^{1

2

3}, James J Cimino^{4

5

6}, Christoph U Lehmann^{7

8

9

10}, Patricia R Sengstack^{11

12}, Joshua C Smith¹³, William M Tierney^{14

15}, Randolph A Miller¹³

Affiliations

¹ Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
² Center for Learning Health System Sciences, University of Minnesota, Minneapolis, Minnesota, USA.
³ Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
⁴ Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁵ Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁶ Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁷ Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁸ Department of Population & Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁹ Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹⁰ Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹¹ School of Nursing, Vanderbilt University, Nashville, Tennessee, USA.
¹² Frist Nursing Informatics Center, Vanderbilt University, Nashville, Tennessee, USA.
¹³ Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
¹⁴ Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.
¹⁵ Department of Population Health, University of Texas at Austin Dell Medical School, Austin, Texas, USA.

Abstract

A panel sponsored by the American College of Medical Informatics (ACMI) at the 2021 AMIA Symposium addressed the provocative question: "Are Electronic Health Records dumbing down clinicians?" After reviewing electronic health record (EHR) development and evolution, the panel discussed how EHR use can impair care delivery. Both suboptimal functionality during EHR use and longer-term effects outside of EHR use can reduce clinicians' efficiencies, reasoning abilities, and knowledge. Panel members explored potential solutions to problems discussed. Progress will require significant engagement from clinician-users, educators, health systems, commercial vendors, regulators, and policy makers. Future EHR systems must become more user-focused and scalable and enable providers to work smarter to deliver improved care.

Keywords: HITECH act (American Recovery and Reinvestment Act); burnout; cognition; documentation; electronic health records; professional; psychological.

Publication types

Editorial
Comment

Grants and funding

UL1 TR003163/TR/NCATS NIH HHS/United States