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Physicians Still Struggle To Find EHR Value

Posted on July 18, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study by Physicians Practice magazine suggests that medical groups still aren’t getting what they want out of their EHRs, with nearly one-fifth reporting that they’re still struggling with an EHR-related drop in productivity and others still trying to optimize their system.

Physicians Practice surveyed 1,568 physicians, advanced practice providers across the U.S. as part of its 2016 Technology Survey. Nearly a third of respondents (31.9%) were in solo practice, and 34% in 2 to 5 physician practices, with percentages largely dropping as practice sizes grew larger.

Specialties represented included pediatrics (17.5%), family medicine (16.2%), OB/GYN (15.2%), psychiatry (12%), internal medicine (10.6%), surgery (2.9%), general practice (2.7%) and “other” at 22.9% (led by ophthalmology). As to business models, 63.3% of practices were independently-owned, 27.9% were part of an integrated delivery network and the remaining 8.8% were “other,” led by federally-qualified health centers.

Here’s some interesting data points from the survey, with my take:

  • Almost 40% of EHR users are struggling to get value out of their system: When asked what their most pressing technology problem was, 20.3% said it was optimizing use of their EHR, 18.9% a drop in productivity due to their EHR, and 12.9% a lack of interoperability between EHRs. Both EHR implementation and costs to implement and use technologies came in at 8%.
  • EHR rollouts are maturing, but many practices are lagging: About 59% of respondents had a fully-implemented EHR in place, with 14.5% using a system provided by a hospital or corporate parent. But 16.8% didn’t have an EHR, and 9.5% had selected an EHR (or a corporate parent had done so for them) but hadn’t fully implemented or optimized yet.
  • Many practices that skip EHRs don’t think they’re worth the trouble and expense: Almost 41% of respondents who don’t have a system in place said that they don’t believe it would improve patient care, 24.4% said that such systems are too expensive. A small but meaningful subset of the non-users (6.6%) said they’d “heard too many horror stories.”
  • Medical group EHR implementations are fairly slow, with more than one-quarter limping on for over a year: More than a third (37.2%) of practices reported that full implementation and training took up to six months, 21.2% said it took more than six months and less than a year, 12.8% said more than a year but less than 18 months, and 15.7% at more than 18 months.
  • Most practices haven’t seen a penny of return on their EHR investment: While just about one-quarter of respondents (25.7%) reported that they’d gotten ROI from their system, almost three-quarters (74.3%) said they had not.
  • Loyalty to EHR vendors is lukewarm at best: When asked how they felt about their EHR vendor, 39.7% said they were satisfied and would recommend them, but felt other vendors would be just as good. Just over 16% said they were very satisfied. Meanwhile, more than 17% were either dissatisfied and regretted their purchase or ready to switch to another system.
  • The big EHR switchout isn’t just for hospitals: While 62.1% of respondents said that the EHR they had in place was their first, 27.1% were on their second system, and 10.8% their third or more.

If you want to learn more, I recommend the report highly (click here to get it). But it doesn’t take a weatherman to see which way these winds are blowing. Clearly, many practices still need a hand in getting something worthwhile from their EHR, and I hope they get it.

Are most doctors really incapable of successful EHR use?

Posted on June 6, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Over the weekend, I read an interesting article on PhysiciansPractice.com that basically said most doctors are not capable of being successful with adopting EHR systems.  It was such a defeatist attitude that I just had to comment on it here.  I mean, come on.  We’re dealing with professionals who grew up at the top of their classes in school, merited entry into a highly-selective, Mensa-level institution called medical school, and then survived all the hurdles through residency and possibly a subspecialty fellowship.  Hollywood worships doctors and spins out TV shows and movies about these alleged smartest members of our society.  And we’re supposed to buy that an EMR system is just too hard to adopt?  Just because it’s a computer system, I suppose?

While I do agree that we should study why most physicians have not adopted an EHR system in their practices, I think there are many more logical reasons for the so-called “failure” to adopt.  To me, it seems less likely to be a true failure and more likely an active decision (or refusal).  I also think that there are obvious considerations with the potential to contribute to this decision.

1.  Paper is easier to master than EHR systems.  Doctors can scribble a few, quick notes and not worry about format, about as complex as  using a Post-It sticky note.  In 99.9% of patient visits, the notes never see the light of day by an auditor or insurance company.  No one ever really asks to see them.  The payments are just rendered by the insurance company automatically when an electronic claim is sent in.

2.  Paper is cheaper and takes no investment of time or training and very little immediate investment of money.  A patient chart the thickness of a ream of paper basically costs about $4, plus pen ink, and doctors get a ton of free pens from various vendors of just about everything.

3.  Incentive programs only work right now if you see a significant number of Medicare or Medicaid patients, and not all doctors do.  I was only seeing 6% of my patient population as Medicare in 2010.

4.  The hoops established by CMS will only get more intrusive and obtrusive in the future, and most doctors know this due to simply reading newspapers and newsletters.

5.  The potential penalties for non-adopters are around 1.5-2% of Medicare/Medicaid-only income.  A lot in absolute terms, but not so when relatively speaking.

So my final thought is that, while I love my EMR system, I’m not doing it for money or necessity.  I’m doing it because along with the right EMR system comes other efficiencies, environmental friendliness, and hopefully a better quality of patient care.  Oh, and back to my original point, yes, I actually think that pretty much all doctors are perfectly capable of adopting an EMR system.

 

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.