EMRs May Trigger Physical Complaints

The electronic medical records revolution is expected to bring vast improvements to patient management, error prevention and workflow efficiency, but it could also spark a rise in musculoskeletal injuries among end users, says a researcher who's studying the healthcare workplace.

"Many hospitals are investing heavily in new technology with almost no consideration for principles of ergonomics design for computer workplaces," says Alan Hedge, PhD, a professor of human factors and ergonomics at Cornell University in Ithaca, N.Y. "We saw a similar pattern starting in the 1980s when commercial workplaces computerized, and there was an explosion of musculoskeletal injuries for more than a decade afterward."

Dr. Hedge and Tamara James, an ergonomist at Duke University Medical Center, have assembled a pair of studies on the subject. In one, presented at the Human Factors and Ergonomics Society's annual meeting in October, they surveyed 179 physicians at Duke's clinics on their computer use and related repetitive strain injuries. They found that many reported neck, shoulder, and back pain on a weekly basis.

In the other study, published in the book Advances in Human Aspects of Healthcare, 180 physicians and 63 nurse practitioners and physician assistants at Duke reported that their increased computer use had reduced their face-to-face interaction with patients. It was not, however, accompanied by increased education on or practice of ergonomic habits. "We can't assume that just because people are doctors or work in health care that they know about ergonomics," says Dr. Hedge.

The ultimate risk of poor ergonomics, he notes, is physician and staff absences or disabilities, or even medical errors, due to pain and fatigue. "In a lot of hospitals and medical offices, workplace safety focuses on preventing slips, trips and falls and on patient handling, but the effects of computer use on the human body are neglected."

David Bernard