Docs don’t routinely report patient symptoms in EHRs

Primary care physicians do not routinely put patient-reported symptoms regarding sleep, pain, anxiety, depression and low energy or fatigue into electronic health record systems.

That’s among the findings of a study published in the December issue of the peer-reviewed journal Quality of Life Research.

In addition, most EHR systems are not designed to include patient-reported symptoms, according to Regenstrief Institute investigator Kurt Kroenke, MD, senior author of the study.

“The healthcare system spends a lot of money on lab and imaging test results, which we put into the patient’s EMR—shouldn’t we be valuing patient-reported symptoms enough to put them into that same record?” Kroenke says.

“We, healthcare systems and the doctors who work in these systems, haven’t figured out how to deal efficiently with symptoms,” he adds. “Some doctors want to know about symptoms, but others don’t see how they can work discussion and follow-up on symptoms into an already busy primary care visit.”

At the same time, Kroenke notes that simply putting patient symptoms—which often go unrecognized and undertreated by busy clinicians—into the EHR won’t address the problem by itself. The key, he says, is making the information actionable in the context of a primary care physician visit.

“It takes a bit of time to talk about these things that are important,” Kroenke comments. “We can’t just put symptoms in the electronic records and give it to the doctors without telling them how to incorporate extra time into the visit to deal with it.”

The study, funded by the Patient-Centered Outcomes Research Institute, revealed that patients want to tell their physicians about their symptoms and would be willing to do so through a computerized patient reporting system. However, researchers reveal that patients interviewed for the study were reluctant to report symptoms if they perceive busy clinicians will not use that information to improve care.

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“Barriers exist and doctors shouldn’t be blamed for not focusing on pain, depression and anxiety—they need efficient clinical strategies to deal with symptoms and reimbursement to pay for these strategies,” adds Kroenke. “Extra time during the patient visit, getting nurses and other non-physicians involved, telecare, online and other self-management tools have the potential to help physicians help their patients deal with symptoms.”