Monday, February 10, 2014

Usability and Cost Cited as Cause of Physician Dissatisfaction with Electronic Health Records

High cost and poor functionality of EHRs outweigh benefits to many physicians

A new national survey of nearly 1,000 physicians conducted for Medical Economics from November to December 2013 by The MPI Group (967 respondents with an approximate +/-3.2% margin of error) shows widespread dissatisfaction related to the functionality and cost of these patient record systems. About 45% of physicians believe patient care is actually worse as a result of adopting EHR technology, two-thirds would not purchase their current EHR system again, and 43% of physicians say these systems have resulted in significant financial losses. In addition, the current state of technology has not improved the coordination of care with hospitals, physicians say.

The survey results corroborate recent national reports from the RAND Corp. scolding the health IT industry for creating systems that interfere with patient-doctor communication, are cumbersome to use, time-consuming for physicians to enter data, and don't communicate well with hospital systems or other physicians. All of these factors are helping to contribute to professional dissatisfaction as was born out by the new survey.

Results from the Medical Economics survey include:
  • 67% say that system functionality influences their decisions to purchase or switch systems
  • 48% say that cost is influencing their decisions to purchase or switch systems
  • Nearly half of physicians say that implementation of EHR systems has made the quality of patient care worse
  • 69% of respondents say that coordination of care with hospitals has not improved
  • 45% say they have spent more than $100,000 on an EHR
  • 77% of the largest practices (more than 10 physicians) spent more than $200,000 on an EHR
  • 38% doubt their systems will still be viable in 5 years
Georgiann DeCenzo, executive vice president of Advanstar Medical Communications Group, a healthcare media division that includes Medical Economics, says, "These results showcase a major disconnect between the goals of the government's EHR incentive program for providers, and the implementation of these systems. Physicians are giving the healthcare information technology sector valuable insight on their customers' preferences, and vendors should factor this into their future development plans."

Medical Economics collected hundreds of comments from physicians about EHR systems. While recognizing the benefits of health IT, many physicians also complained of workflow issues, and problems with usability and cost. They also offer some very good advice if you are considering switching EHRs - and this year that is likely to happen quite a bit as vendors which were previously certified struggle to achieve certification in the 2014 Edition, and as previously Complete Certified EHR Technology is only able to attain Modular Certification thus requiring either additional modules or a complete rip and replace.

There is no doubt in my mind that the smart use of health IT will improve care and lower costs, and I am not all surprised at some of the pain points that surface in this survey. Important things that are worth doing are rarely easy to accomplish. Our entire health system is undergoing a radical transformation, and the IT infrastructure to support this is barely in place. Physician satisfaction will be a key linchpin in the success of this transformation, and my hope is that we can truly look out for the little guy and avoid the creation of a healthcare digital divide between large health systems and physicians practices, especially those practicing in rural and underserved communities.

Most Physicians would not purchase the same EHR system today