A Stanford Medicine survey conducted by The Harris Poll found that more than 6 in 10 primary care doctors say electronic health records have led to improved patient care. However, a majority also report frustration with how the demands of the digital systems affect their relationships with patients.

The survey illustrates the gap between the potential and current reality of the documentation technology, says Lloyd Minor, dean of the Stanford School of Medicine.

Two-thirds of doctors report being at least somewhat satisfied with their electronic health records system, though 4 in 10 say the records bring more challenges than benefits, according to the survey. About 7 in 10 physicians say EHRs take valuable time away from patients, and an equal percentage say the systems contribute greatly to burnout.

Of 31 minutes devoted to a patient, doctors estimate they spend 12 interacting with the patient, eight interacting with the records systems during the visit, and another 11 minutes on the computer after the visit, according to the poll.

Though data entry required by digital systems can be burdensome, local culture and workflow can influence how physicians regard their EHR experience.

Taylor Davis, vice president of analysis and strategy for KLAS, a company that compiles and analyzes user feedback on health information technology for vendors, says surveys with more than 20,000 respondents found that organizations with the most satisfied workers were not the ones with cutting-edge technology, but those that emphasized teamwork, training and understanding how to use the system.

“These are organizations where physicians realize that it’s a myth that the [EHR] is going to be intuitive enough that I can just pick it up and use it out of the box,” Davis says.

Some organizations report using data gleaned from EHRs to inform and improve care. Stanford Children’s Health devised a tool that collects information on cases of jaundice in premature infants to be analyzed alongside expert-based consensus to ensure best practices continue to be followed as they evolve. Intermountain Healthcare created a transportation program for Medicaid patients after an analysis of patient records revealed that a main reason they were visiting the emergency department for nonurgent care was lack of transport.

At Kaiser Permanente, Brian Hoberman, a physician, says there have long been numerous opportunities for healthcare based on patient data, and identifying patients that need a particular service is not difficult. One challenge is prioritizing which health needs to tackle with the data. Another is addressing the occasional barrier from individual patients’ lives.

“We’re able to find folks who need to come in to manage their diabetes or hypertension, and we’re able to actually pick them up,” Hoberman says. “That doesn’t necessarily mean that they’re going to choose to come in, for whatever reason.”

Engaging patients more actively in their care has been a major benefit of electronic health records. Through portals created for them, patients have started participating more in decision-making and care planning, says Judy Murphy, chief nursing officer with IBM Global Healthcare. Patients are now thinking more about healthcare as a way of life rather than as episodic encounters, she says: “That has been a huge boon to the way we think about care in the U.S.”

Patients, as consumers accustomed to the online retail experience, would drive innovations in electronic health records — particularly as they assume more of the health care risk because of developments like high-deductible insurance plans.

A big step forward is the new Apple Health Records application programming interface, says Donald Rucker, national coordinator for health information technology at the U.S. Department of Health and Human Services. The API will allow developers to create apps that can use electronic health records data to help people manage their health care, medications and more.

“Some of the more esoteric things — the machine learning, all of that — will piggyback off that broader consumer involvement, the way it does in other industries,” Rucker says.

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