![]() ![]() Other studies report that the use of the EHR takes about 30% of the consultation time with patients. In a medium-sized hospital, primary care physicians would spend 44% of their time on clerical work, and only 24% on communication and direct clinical contact with the patient. In the USA, a study on ambulatory care reports that physicians spend almost 50% of their time on EHRs and office work while only a third of their time is devoted to clinical work. These findings, which were observed across several IT-based tools and systems deployed in Quebec over several years (1994–2015) and also in other contexts, are in line with recent studies showing that EHRs have important consequences on clinical practice. Interoperability: the parallel utilisation of various non-integrated technological applications (e.g., doctor’s records, patient’s records, pharmacist’s records) may force health care providers to enter the same information several times (a form of “human interoperability”) or to search for information dispersed in different systems. The “alert fatigue” phenomenon may lead some health care providers to ignore alerts or disable alarm systems, which may have dramatic consequences for the patient.Ĭognitive overload: the manipulation of large amounts of data and information lead to cognitive overload, exhaustion and health care providers’ sense of ineffectiveness. ![]() The dysfunction and/or rigidity of the technology engender situations of frustration and stress, even discouragement for health care providers (e.g., false alarms, configuration problems, disconnection of systems after a period of inactivity). Technology as a control tool: the possibility of using IT solutions as a means of controlling their activity is seen by health care providers as a challenge to their agency within the organization (due to the “asymmetry of information” upon which such systems are based), therefore of their autonomy of practice.Īnxiety and stress: in several situations, IT solutions may be experienced as a burden. This rigidity is also perceived as limiting health care providers’ opportunities for innovation, inventiveness and creativity in their practice. ![]() By questioning their autonomy and decision-making capacity, IT solutions may push health care providers to feel that they are at the service of technology. Health care providers thus have to align with the “technology-driven” scenarios. Misalignment of technology and the clinical context: technology providers may prioritize major clinical-administrative scenarios that are not always adapted to the specificity of practice and organization of services in hospitals. Technology also creates a feeling of isolation for some health care providers, particularly because of reduced contact time and informal “corridor” discussions with colleagues and other partner teams. It showed that IT solutions, which often interface with EHRs, could contribute to the deterioration of health care providers’ work conditions in different, but interconnected ways :ĭecreased contact and communication time: when clinical consultations are more technology-oriented, a sense of depersonalization of the patient-clinician relationship emerges. In our analysis of 10 major projects in Quebec (Canada), we examined the unintended consequences of Information Technology (IT) solutions in healthcare. Unintended consequences of information technology-based tools and systems In order to show how the quadruple aim can help to rethink how EHRs are designed and implemented, this paper clarifies the lessons that can be drawn from considering the unintended consequences of information technology-based tools and systems. These consequences enter in contradiction with the quadruple aim, which suggests that the well-being of health care providers is essential to any strategy that seeks to improve the quality of care, including patient experiences. These elements have been associated with increased frustration, dissatisfaction, stress, and exhaustion of health care providers. This situation is mainly attributed to the tedious and time-consuming workload imposed by data entry for administrative and billing purposes, constraints related to inappropriate interfaces and ergonomics, and EHR interoperability issues. Recent studies report that electronic health records (EHRs) have come to play an important role in the deterioration of work conditions for health care providers. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |