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Physicians May Overestimate EHR Capabilities

Three-quarters of doctors surveyed say their electronic health records systems can help them show Meaningful Use, but other polls challenge that optimistic view.

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Fifty-five percent of office-based doctors said they had electronic health records (EHRs) of some kind in 2011, according to a survey by the National Center for Health Statistics (NCHS), a unit of the Centers for Disease Control and Prevention (CDC). Of those physicians, three-quarters said their systems could help them meet the government's Meaningful Use criteria.

According to the results of another CDC survey, released earlier this year, 57% of physicians had EHRs in 2011, but only 34% of them met the CDC's definition of a "basic" EHR. Such an EHR includes a patient's history and demographics, a problem or diagnosis list, physician notes, medications, allergies, electronic prescribing, and the ability to view laboratory and imaging results electronically.

Even that doesn't encompass all that an EHR certified for Meaningful Use must include, such as decision support and interoperability features. In fact, only 11% of physicians planned to apply for the government's EHR incentives and had systems capable of meeting the majority of Meaningful Use objectives, according to a study published in Health Affairs in May.

So why did so many physicians in the second CDC report say their EHRs could enable them to show Meaningful Use?

Catherine DesRoches, senior survey researcher at Mathematica Policy Research, told InformationWeek Healthcare that in the first survey, the researchers actually measured the functions that doctors said their EHRs had. In the second poll, they just asked whether the physicians had a full EHR, a partial EHR, or nothing, and whether the EHR users believed they could show Meaningful Use.

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It's possible, she said, that many physicians overestimated the capabilities of their systems or didn't understand the Meaningful Use criteria. It's also possible that some had upgraded their systems or bought new EHRs to qualify for government incentives, she said.

The new CDC report also found that nearly half of the respondents who weren't using EHRs said they had either purchased one or planned to in the next 12 months. According to the researchers, this suggests there will be a major surge in EHR adoption in 2012.

DesRoches isn't so sure. The 21% of non-EHR users who said they'd already purchased an EHR would probably have them up and running within 12 months, she said. But 27% of the non-users merely said they planned to buy an EHR within a year. Considering the length of time it takes to select, purchase, and implement an EHR, she noted, most of that contingent probably won't be using an EHR until next year, at the earliest.

According to the latest survey, 85% of physicians who had EHRs were "very" or "somewhat" satisfied with their systems. Three-quarters of the respondents said that EHRs enhance patient care. Among the benefits cited by doctors were the ability to access patient records remotely (74%), be alerted to critical lab values (50%), be alerted to potential medication errors (41%), and be reminded to provide preventive care (39%).

A 2008 survey that DesRoches helped conduct had similar results, she noted. "Physicians who had implemented a system were very satisfied with it. They thought it improved the quality of their clinical decisions. Many said it had prevented an error."

The other major finding of the latest CDC survey is that 59% of physicians used a standalone EHR based in their offices while 41% used a Web-based EHR. DesRoches attributed that partly to the fact that Web-based EHRs are newer, so physicians who have had EHRs for a while would be more likely to have standalone systems.

Nevertheless, it's notable that 41% of the respondents are using Web-based systems. In the past few years, those systems have become more numerous and more capable as some vendors have come out with Web-native EHRs. Yet, the report noted, some respondents said that standalone systems offer faster response times than Web-based EHRs and that their maintenance costs are lower.

Perhaps as the technology improves and physicians become more accustomed to storing their data in the cloud, DesRoches suggested, Web-based systems will become more popular.

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User Rank: Apprentice
7/20/2012 | 10:39:10 PM
re: Physicians May Overestimate EHR Capabilities
Meeting Meaningful Use is only half the battle using any EHR. It has been an up hill battle with getting doctors on board along with their staff. The cloud based EHR is difficult to trust. But after the past two years of storing data in the cloud, doctors are just staring to feel at ease about the whole process and starting to not give it a second thought. The cloud based EHR has allowed for a greater workflow and expansion of the people able to work extending the office to billing and coding and transcriptionist. This expansion has added greater depth to a patients chart.

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