Benefits of Structured Narrative Notes

The Benefits of Structured Narrative Notes:

Efficiency:  Physicians report that EMR data entry can add from one to two hours to their workday, or cause them to see several fewer patients per day.  Structured narrative notes allow physicians to continue dictating, which is preferred by the vast majority of physicians.

Clarity:  Narrative notes preserve the patient’s story and make one patient distinguishable from the next.  They are the primary method by which clinicians share information about patients, important for continuity of care under meaningful use.  Finally, narrative notes are concise and enable clinicians to focus on pertinent information.
 
Accuracy:  Physicians are often pressed for time when documenting patient care and, as a result, they make documentation errors.  Studies have shown that notes entered directly into an EMR have high error rates (80% or more), and physicians make more errors than other clinicians when using direct text entry. By contrast, narrative notes produced via transcription approach a 0% error rate due to editing and quality control processes.

Usability:  A survey by Nuance found that “90% percent of doctors surveyed said they are either ‘concerned’ or ‘very concerned’ about usability as a leading obstacle to EHR adoption.” A recent study found clinical notes generated by EMRs are less useful because pertinent information is hard to find, less trustworthy due to “cut and paste” notes with repetitive information, and less accurate due to direct text entry errors. Structured narrative notes can eliminate these usability barriers.