Table 1.

Reactions and Reframed Responses to Electronic Health Record Systems

Reaction to EHR use	Reframed current state
Our EHR doesn’t improve care as rapidly as we would like.	• Resources and staff dedicated to EHR improvements are limited and may need to be prioritized.
Our EHR is too complex to be useful.	• EHRs are attempting to represent complex processes that vary both within and across providers and institutions.
The EHR should be able to accommodate the wide range of clinical decisions I need to make.	• Reducing variation in clinical care also represents an opportunity to improve the EHR.
The EHR exists primarily to support checkbox tasks and billing.	• Billing and other clerical tasks are not likely to go away, so approaches to reducing burden on providers may require reexamination of how and why such tasks are carried out or consider supporting them outside the EHR.
Documentation is all I do.	• In order to reduce documentation burden, it may be most important to first consider what information needs to be documented in each note or should be discoverable in the EHR.