Why EHRs Actively Constrain Ideal Clinical Workflows
Clinicians Agree: Problem-Oriented Documentation Just Makes Sense
When you ask most clinicians what kind of documentation structure would make their lives easier, the answer is often the same: problem-oriented documentation. It’s simple, clear, and keeps each clinical issue organized in a way that’s both intuitive and useful for follow-up care. Problem-oriented documentation allows clinicians to focus on each medical issue independently, so relevant history, labs, and treatments are organized together, not buried in the broader record.
So Why Aren’t We All Using It? The EHR Straightjacket
Despite the clear advantages, many clinicians still shy away from problem-oriented documentation. And the reason isn’t about their preference or training—it’s about the limitations of EHRs.
Most EHR systems today were designed to replicate paper charts, not to innovate documentation workflows. Instead of adapting to meet clinicians’ needs, EHRs enforce rigid, predefined structures that rarely align with the way clinicians think or work. They standardize documentation around a single format, usually SOAP (Subjective, Objective, Assessment, Plan), and make it difficult, if not impossible, to organize data in ways that reflect real-world clinical workflows.
How EHR Constraints Impact Documentation Quality
Let’s take a look at some of the ways EHRs actively constrain ideal workflows:
1. Rigid Formats Enforce One-Size-Fits-All Documentation
Most EHRs only allow one style of documentation, and it’s usually a single, all-in-one format. For complex cases involving multiple issues, this lack of flexibility means that clinicians must combine everything into a single note—mashing together unrelated information just to fit within the EHR’s boundaries.
2. Limited Support for Problem-Specific Documentation
When clinicians try to organize data around specific medical problems, they hit roadblocks. Most EHRs lack dedicated fields or sections for individual issues, so clinicians are forced to use workaround solutions. This often results in bloated, confusing notes that don’t provide a clear picture of the patient’s care.
3. An Inability to Adapt to Clinical Complexity
EHRs don’t allow clinicians to adjust workflows based on patient needs or visit types. Whether a patient has a single issue or multiple chronic conditions, clinicians must use the same rigid template. This lack of flexibility means that documentation doesn’t reflect the complexity of the case, reducing the utility of notes for future visits.
4. Documentation Becomes a Burden, Not a Tool
When clinicians are forced to document in ways that don’t match their thinking, documentation becomes a burden. Instead of serving as a tool to support clinical decision-making, it becomes a task to “get done.” Clinicians end up checking boxes and filling in fields, rather than thoughtfully documenting each issue in a way that supports ongoing care.
The Impact of Guardrails on Clinical Decision-Making
EHRs weren’t built to support problem-oriented documentation, and that’s a missed opportunity. When clinicians are constrained by inflexible structures, they can’t document in ways that support their decision-making process. This impacts patient care: when notes are disorganized, future clinicians have a harder time understanding the full history of each problem, and critical details can easily get lost in the noise.
With EHRs set up as they are, clinicians often end up using “data dumps” just to ensure information is captured in one place. This leads to bloated, redundant notes, making it difficult for any reviewer to discern the relevant details. In other words, documentation becomes cluttered and less useful.
How River Records Is Breaking the Mold
At River Records, we believe documentation should support clinicians, not constrain them. Our platform is designed with flexibility in mind, adapting to problem-oriented workflows rather than enforcing a rigid structure. Here’s how we’re different:
• Adaptable to Problem-Oriented Documentation: River Records lets clinicians document by problem, keeping each issue clear, organized, and relevant.
• Support for Complex Cases: Our flexible framework is built to handle complex cases, where clinicians can organize information as they need, without being forced into a one-size-fits-all format.
• Dynamic Workflows: We know that clinical care isn’t static, and neither are our documentation tools. River Records lets clinicians adjust documentation structure to suit the case, visit type, and patient needs.
Conclusion: It’s Time for EHRs to Evolve
EHRs should enhance clinical workflows, not hinder them. It’s time to move away from rigid documentation structures that don’t serve clinicians or patients, and to build tools that support the real-world needs of healthcare providers. At River Records, we’re paving the way for documentation that’s flexible, problem-oriented, and ready to meet the demands of modern clinical care.
Isn’t it time documentation fit your workflow, not the other way around?
