It had Physicians trading in their hand-written files and folders for digital tablets, which seemed like progress, but it had unintended devastating consequences on the quality of medical care and the morale of Physicians.

“The growth in poorly designed digital health records and quality metrics has required that physicians spend more and more time on tasks that don’t directly benefit patients, contributing to a growing epidemic of physician burnout,” said co-author Ashish Jha, a Veterans Administration Physician and professor at Harvard Chan School of Public Health.

If you’ve never had to fill out a Patient record and comply with HERT, ACA and MACRA rules, you might think this is much ado about nothing. What’s so horrible about having to do a little extra paperwork—especially if it means more comprehensive and accurate health records? The fact is that the templates and software available for Physicians to use to complete Patient records are inefficient, time-consuming, cumbersome and decidedly user unfriendly sending the Physician on a journey of endless mouse clicks that seem to lead nowhere.

The article “How many clicks does it take…?” for the Lown Institute sums it up best. “How many licks does it take to get to the tootsie roll center of the Tootsie Pop? The world may never know. But we do know how many clicks in an electronic medical record (EMR) it takes for clinicians to perform even the most basic tasks.”

For instance, how many clicks to get a flu shot? According to Lown, one Doctor reported that it took 32 clicks to just order and record one flu shot. Since in many cases only a Doctor can fill out these compliance forms, imagine how many flu shots a practice can issue in a week and how onerous recording them can be for a single Doctor.

They also report that the situation is worse when you consider the hectic environment of an emergency department. A 2013 study in the American Journal of Emergency Medicine discovered that the average total number of mouse clicks for a ten-hour shift was 4,000. Physicians in ER used up almost half their time on electronic paperwork and clicks, while only being able to devote little more than one fourth of their time with their Patients.  Think about it. When’s the last time your Doctor looked you in the eye when you were describing what was ailing you? How often did he take his eyes off his computer and tablet as he rattled off a list of questions that seemed irrelevant to the reason for your visit?

There are good intentions and reasons for instituting ways to improve information technology in health care, but there is such a thing as too much information. In a database that is not easily searchable and full of alerts that pop up like spam, checking a Patient’s history could be like finding a needle in a haystack—a haystack that the compliance program has created. And the worst part is that the information overload can cause life-threatening medical error when “alert fatigue” can cause a Physician treating an infection to mistakenly click through valid alerts like an allergy to penicillin. No wonder that having their hands tied this way has left some Physicians with a feeling that the only option they have is to leave their practice.

It can be argued that technology and bureaucracy have caused this contributing factor to Physician shortages, but we have the technology to change the system. Now all we need is the will and resources to get it done. The answer is not going back to the days of coffee-stained manila folders with illegible hand-written entries. We do live in a digital world, but our Physicians and Patients deserve a record keeping system that does not detract from Patient care and make practicing Medicine a red tape nightmare. And after that, if smaller practices still need help in complying with record keeping, give them the financial and technical support to help them. 3

Health Information Technology for Economic and Clinical and Health Act (HITECH, 2009), the Medicare Access and CHIP Reauthorization Act (MACRA, 2015) and the Affordable Care Act (ACA, 2010)

*  White Paper

2  The Lown Institute