The medical problem list, an important feature within the electronic health record (EHR), is intended to be a quick reference guide to a patient’s primary health issues. It aims to provide a concise, current summary that aids clinicians in making informed decisions. Yet, feedback from our recent study involving 300 clinicians reveals widespread frustration with this tool.
Providers highlighted several concerns in our survey, emphasizing the problem list’s contributions to issues like clinician burnout while identifying opportunities for making problem lists more effective. Common criticisms revolved around lists being cluttered with outdated, redundant, or inaccurate information. These issues, according to many, are taking up valuable time and pose potential risks to patient safety.
Luckily, improvements can be made. In the survey, participants said they saw significant potential in reorganizing medical problem lists to help enhance patient care and alleviate clinician stress.
For findings and direct quotes from participants, click below to download the survey, The problem with the medical problem list: Evaluating its impact and paths to improvement.
SURVEY
The problem with the medical problem list:
Evaluating its impact and paths to improvement
Want to know what providers found most frustrating when using a traditionally structured medical problem list? Continue reading for an excerpt.
Finding: Providers are frustrated by wasted time when dealing with problem lists, and problem lists that have inaccurate and redundant issues are a major issue.
Providers cited several specific frustrations when reflecting on their experiences with problem lists, mostly lamenting the time it takes to manage them. Overall, 51% said that navigating problem lists was too time-consuming. However, many cited other concerns, including:
- 32% had significant issues with the traditional format itself (reverse chronological order);
- 28% said the accuracy of problem lists was a huge issue;
- 26% don’t think problem lists fit into a patient visit flow; and
- 23% haven’t found problem lists helpful or informative in their experience.
Inaccurate problem lists can waste clinicians’ time, threaten patient care, and create even more issues. When asked what their biggest concern was when problem lists are inaccurate, clinicians in the study were split:
- 51% cited a threat to patient care – with 25% saying it could cause less effective care and 26% who said inaccurate problem lists increase the potential for more clinical errors;
- 30% said inaccuracies in problem lists just wasted their time;
- The remainder of providers cited other concerns, including poor patient experience and issues with reimbursement and billing.
The IMO study also found that problem list usability and inaccuracy were consistent themes across the provider’s responses. However, the most common theme in the open-answer section of the study was “redundancy” within problem lists. Though expressed in many ways, respondents repeatedly expressed annoyance about duplicate or too-similar patient issues, cluttering problem lists and distracting or even confusing them.
