The Health Record Crisis

Too often, doctors and nurses see each other as fighting separate battles, and sometimes against each other. Doctors blame nurses, and vice versa, for the failings of the health care system.

Instead, nurses and doctors should try to put our differences aside and work together to achieve real change, starting with a pernicious problem that drives so much of our mutual discontent: electronic health records.

Clinicians are notoriously overworked, but ask anyone on a hospital staff, and he or she will tell you that workloads have become heavier the last several years thanks almost entirely to the arrival of electronic health records—detailed reports about a patient’s medical history and care. Originally intended as a work-saving tool, the records have gone in the opposite direction, taking time away from patient care in the name of electronic box-checking.

A new report from the National Academy of Medicine says that on average nurses and doctors spend 50 percent of their workday treating the screen, not the patient, and that “increased documentation time” associated with electronic health records can lead to burnout. Burnout is also tied to finishing documentation at home, a necessity for many physicians, and for nurses who provide home care.