As hospitals and health networks struggle to implement EHRs and comply with federal regulations, medical laboratories have their own struggles fulfilling orders while dealing with physician burnout

Ever since 2009, when the federal government’s electronic health record (EHR) adoption initiatives first became law, hospital medical laboratory managers have watched their parent healthcare organizations struggle to implement behemoth information systems and comply with new federal adoption and data reporting regulations. In most instances, not entirely successfully.

Ten years and billions of dollars in incentives later, not much has improved. EHRs still lack a common interoperability protocol. And health networks still struggle to comply with federal information exchange requirements, while simultaneously engaging with Medicare data reporting schemes that treat patient data as a form of currency.

However, during that same ten years, clinical laboratories and anatomic pathology groups have been successful in implementing interfaces with physicians’ EHRs to support lab test orders and results reporting.

EHR Costs and Physician Burnout Increasing

In the current climate of acquisitions and mergers in the healthcare industry, health networks often find themselves patching together a mix of disparate, incompatible EHRs. All while the cost of implementing EHR systems is increasing.

And medical laboratories that must maintain APIs (application programming interfaces) for data exchange with these changing systems are finding themselves between two front lines: hospitals and EHR developers.

Tragically, there’s also growing evidence that EHRs contribute to physician burnout, a well-known industry problem that Dark Daily reported on in multiple e-briefings.

For example, a 2017 study published in the Annals of Family Medicine (AFM) found that primary care physicians spend more than 50% of their time working on tasks associated with EHRs instead of caring directly for patients.

A similar 2016 study published in the Annals of Internal Medicine (AIM) found that “For every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another one to two hours of personal time each night doing additional computer and other clerical work.”

And last year, Stanford University School of Medicine researchers published a study in Mayo Clinic Proceedings which concluded that physician burnout may be as big a cause of medical errors as unsafe healthcare environments!  

“In addition to the cost of procurement and deployment, we’re also seeing subsequent increases in higher IT operating costs, higher departmental operating costs. We’re also seeing lower productivity and lower employee satisfaction,” Scott Kolesar, Americas  Health Technology Innovation and Digital Leader for multinational professional services firm Ernst and Young, told Modern Healthcare.

This may be an understatement.


“Where the debate about EHRs still comes in is doctors changing the way they practice and spending an awful lot of time doing data entry type of things,” Michael Burger, a senior healthcare information technology consultant specializing in both clinical and administrative systems and processes at health IT management consultants Point-of-Care Partners, told Modern Healthcare. “They push back to say, ‘We’ve made this enormous investment, and in the end, I’m not sure the care I’m providing is any better or less expensive than if I were doing it on paper.’” (Photo copyright: Point-of-Care-Partners.)

Massive Amounts of Money

The news, however, isn’t all negative. Some health systems are reporting efficiency gains—particularly in areas of billing—and perhaps surprisingly, in faster clinical laboratory test turnaround times.

A recent report from Allied Market Research (AMR) seems to predict future growth in the EHR industry. “The global EHR market was valued at $23.6 billion in 2016, and is expected to reach $33.3 billion by 2023, growing at a CAGR of 5.0% from 2017 to 2023,” noted an AMR press release.

Nevertheless, the lack of true interoperability could be responsible for a possible reduction in EHR sales as well.

“However, high cost of EHR and increase in concerns regarding the patient data safety and security are expected to impede market growth,” the press release also stated.

So, that’s confusing. One thing is certain, EHRs are not going away.

Indeed, some experts suggest health networks and hospitals view EHR implementation, maintenance, and upgrades as they would any other investment. “If you think of EHRs like any other capital system—a phone system, for instance—they are indispensable, so you have to just put them in your capital plan,” Jon Ivins, Vice President, Partner, and attorney at Hirschler Fleischer who specializes in healthcare disputes, litigation, and regulation, told Modern Healthcare.

For better or for worse, EHRs are here to stay. Hospital and independent clinical laboratory managers and stakeholders will want to note this fact and become even better prepared as the EHR industry continues to develop.

—Dava Stewart

Related Information:

No End in Sight: EHRs Hit Hospitals’ Bottom Lines with Uncertain Benefits

Electronic Health Records (EHR) Market Expected to Reach $33,294 Million by 2023

Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties

Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations

Stanford University Researchers Finds Physician Burnout as Big a Threat to Patient Safety as Unsafe Hospital Conditions; Exhausted Providers Twice as Likely to Make Medical Errors

EHR Systems Continue to Cause Burnout, Physician Dissatisfaction, and Decreased Face-to-Face Patient Care

Physician Survey Finds Burnout and Low Morale Cause Nearly 50% of Doctors to Consider Retirement, Non-Clinical Roles, or Concierge Medicine

Sorting through EHR Interoperability: A Modern Day Tower of Babel That Corrects Problems for Clinical Laboratories, Other Providers

Future EHR Systems Could Impact Clinical Laboratories by Offering Cloud Services and Full Access to Patients on Mobile Devices