New study contradicts notion that electronic health records are driving doctors to quit

August 28, 2018 by Shannon Roddel, University of Notre Dame
Credit: CC0 Public Domain

Prominent journalists including the late Pulitzer Prize-winner Charles Krauthammer, have written that doctors are leaving the practice of medicine because adopting and using electronic health records (EHRs) is frustrating and debilitating.

Not so, according to new research from the University of Notre Dame, which shows that basic EHRs actually have increased doctors' tenure at hospitals, whereas advanced EHRs caused doctors to shift to other hospitals. The study found no evidence of retirements as a result of implementation.

"The Mobility of High Status Professionals after the Implementation of Enterprise Information Systems," forthcoming in Information Systems Research by Corey Angst, professor of IT, Analytics, and Operations in Notre Dame's Mendoza College of Business, examines how the implementation of basic and advanced EHRs influences the ability of organizations to retain highly trained professional workers.

"Specifically, we look at how this usage affects the decision of physicians to continue practicing at their current hospital," Angst says. "Results suggest that when EHRs create benefits for doctors, such as reducing their workloads or preventing costly errors, their duration of practice increases significantly. However, when technologies force doctors to change their routines, there is an obvious exodus, though it's more pronounced with older doctors, especially specialists, and those who have been disrupted in the past by IT implementations."

The researchers used information on the mobility of physicians from the Hospital Inpatient Dataset provided by the Florida Agency for Health Care Administration (AHCA), which provides detailed accounts of each patient admitted to Florida hospitals in addition to information on where physicians have been treating patients during the course of the sample. Data regarding EHR implementation were retrieved from HIMSS Analytics, a nationwide survey of healthcare delivery organizations, granting access to information regarding hospital level adoption of EHR systems at the module level, as well as organizational characteristics such as for-profit status, teaching, specialties, vendor information and size, at the year level. When combined, the data offer information regarding physician employment and EHR implementation at the physician-hospital-year level between 2000 and 2010.

"With the ubiquity of EHRs today and federal policies that mandate adoption, there is now 'nowhere to hide,'" Angst says, "but during the timeframe we examined, it was possible for doctors who disliked EHRs to relocate to other hospitals or retire. Interestingly, we did not find increases in retirements or wide-scale departures, but we did find that advanced EHRs did push doctors to less sophisticated hospitals, while basic EHRs actually increased tenure at the hospital."

Advanced EHRs, which utilize CPOE (Computerized Physician Order Entry) or PD (Physician Documentation), are known to be more disruptive to doctors' routines.

"Most doctors don't want to have to look at a screen and document what the patient is saying while doing an exam," Angst says. "The PD module requires doctors to either document the things they are doing at the moment of the exam or immediately following—or they have to employ a scribe to do it while they are doing the patient exam. The CPOE creates alerts that many doctors ignore because they think they know better or because of a known history with the patient. These can be very disruptive and in some cases they require doctors to work around the alert."

Basic EHRs, on the other hand, are more automated but also have been in use longer so doctors are more comfortable with them.

Angst says his team's study offers reassurance that doctors won't be scared off as hospitals continue adopting new technologies—as long as they're not too disruptive to routines.

Explore further: Doctors want substantial improvements in EHRs

More information: The Mobility of High Status Professionals after the Implementation of Enterprise Information Systems. papers.ssrn.com/sol3/papers.cf … ?abstract_id=2893169

Related Stories

Doctors want substantial improvements in EHRs

June 18, 2018
(HealthDay)—Although primary care physicians (PCPs) see value in electronic health records (EHRs), they want substantial improvements, and generally agree on what these improvements should be, according to research from ...

Best practices developed for use of EHR to enhance patient care

May 16, 2018
(HealthDay)—Best practices have been developed for using electronic health records (EHRs) to enhance patient-centered care, according to an article published online in Medical Economics.

Three factors could explain physician burnout

August 17, 2018
In just three years, physician burnout increased from 45.5 percent to 54.4 percent, according to a paper authored by doctors at the University of California, Riverside School of Medicine.

60 percent of peds hospitals have electronic health records

April 17, 2013
(HealthDay)—Since 2008 there has been an increase in the proportion of children's hospitals adopting electronic health records (EHRs), with EHRs in almost 60 percent of children's hospitals in 2011, according to research ...

Report highlights progress, challenges in health IT

September 1, 2014
(HealthDay)—Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood ...

EHR use during patient visit may mean missed non-verbal cues

February 5, 2014
(HealthDay)—Patterns of eye gaze change with the use of electronic health records (EHRs), and this influences physician-patient interaction, according to research published in the March issue of the International Journal ...

Recommended for you

Hybrid prevalence estimation: Method to improve intervention coverage estimations

December 6, 2018
LSTM's Professor Joseph Valadez is senior author on a new study published today in the Proceedings of the National Academy of Sciences, which outlines proposals for a more accurate estimator of health data.

How algorithms can create inequality in health care, and how to fix it

December 5, 2018
Machine-learning algorithms and artificial intelligence software help organizations analyze large amounts of data to improve decision-making, and these tools are increasingly used in hospitals to guide treatment decisions ...

Healthcare providers—not hackers—leak more of your data

November 19, 2018
Your personal identity may fall at the mercy of sophisticated hackers on many websites, but when it comes to health data breaches, hospitals, doctors offices and even insurance companies are oftentimes the culprits.

How AI could help veterinarians code their notes

November 19, 2018
A team led by scientists at the School of Medicine has developed an algorithm that can read the typed-out notes from veterinarians and predict specific diseases that the animal may have.

Patients' experiences with misdiagnosis inform patient safety improvement efforts

November 6, 2018
Diagnostic errors affect an estimated 12 million U.S. adult outpatients annually; however, patients' experiences of these errors are underexplored. To gain insight into the patient perspective, researchers from Baylor College ...

Funder involved in all aspects of most industry-funded clinical trials

October 3, 2018
In most industry funded trials reported in high impact medical journals, all aspects of the trial involved the industry funder, finds a study published by The BMJ today.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.