The impact the Meaningful Use (MU) program has had on EHR adoption in the U.S. is undeniable. According to the 2012 Centers for Disease Control and Prevention survey, only 17 percent of physicians used an advanced EHR in 2008. Today, more than 50 percent of eligible professionals (mostly physicians) have demonstrated MU and received an incentive payment. For hospitals, just 9 percent had adopted EHRs in 2008, but today more than 80 percent have demonstrated MU. This surge in EHR adoption is certainly a huge first step toward improving patient documentation and ultimately cutting costs and enhancing care. However, the EHR MU program won’t get the industry there on its own. In fact, many would argue that the MU program has actually served to stunt EHR innovation. In other words, EHR manufacturers have become so focused on ensuring their software is MU-certified that many have lost sight of the functionality that is truly important to health providers. This sentiment came through loud and clear in a recent survey we conducted with more than 150 healthcare providers. It’s no secret that many end users of EHR technology (especially physicians) are dissatisfied with their experience. However, our survey pinpoints the EHR weaknesses providers find most frustrating and reveals the key changes that would make the software a more valuable tool to clinicians and the healthcare organizations they represent.
Meaningful Use may be driving EHR adoption, but our survey reveals that much more is required from the technology to make it a truly useful tool to healthcare providers.
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The impact the Meaningful Use (MU) program has had on EHR adoption in the U.S. is undeniable. According to the 2012 Centers for Disease Control and Prevention survey, only 17 percent of physicians used an advanced EHR in 2008. Today, more than 50 percent of eligible professionals (mostly physicians) have demonstrated MU and received an incentive payment. For hospitals, just 9 percent had adopted EHRs in 2008, but today more than 80 percent have demonstrated MU. This surge in EHR adoption is certainly a huge first step toward improving patient documentation and ultimately cutting costs and enhancing care. However, the EHR MU program won’t get the industry there on its own. In fact, many would argue that the MU program has actually served to stunt EHR innovation. In other words, EHR manufacturers have become so focused on ensuring their software is MU-certified that many have lost sight of the functionality that is truly important to health providers. This sentiment came through loud and clear in a recent survey we conducted with more than 150 healthcare providers. It’s no secret that many end users of EHR technology (especially physicians) are dissatisfied with their experience. However, our survey pinpoints the EHR weaknesses providers find most frustrating and reveals the key changes that would make the software a more valuable tool to clinicians and the healthcare organizations they represent.
Data Access, Billing Accuracy Key EHR Strengths
Of the more than 150 providers that were surveyed, 55.4 percent represented a hospital or IDN and 24.7 percent represented a group practice.
The most popular inpatient EHR platforms in use at these facilities were MEDITECH (22.1 percent), McKesson (17 percent), Epic (16.2 percent), Cerner (15.4 percent), and Siemens (12.3 percent). Ambulatory EHR systems in use were much more varied, with the most popular platforms being Allscripts (18.2 percent), Epic (14.8 percent), and eClinicalWorks (11.5 percent).
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Not all feedback regarding EHR technology was negative. In fact, most providers were quick to reference the strengths of their respective EHR systems. The most commonly cited EHR benefit was the improved access to patient records and information the software provides (28.6 percent), followed by improved billing and claims accuracy (16.1 percent). These advantages have become the somewhat tame and expected strengths of EHR and not ones that illustrate the significant role these systems are promised to play in transforming our healthcare system. That being said, a respectable number of respondents (12.5 percent) did state that their EHR’s impact in improving the provider’s overall quality of patient care was its biggest strength.
Interoperability, Clinical Workflow Key EHR Weaknesses
Not surprisingly, clinical workflow disruptions and overall interoperability were considered the two biggest weaknesses of today’s EHR software by our survey respondents. Together, these failings were cited as primary pain points for 59 percent of providers surveyed. The overall expense of an EHR came in a distant third, with 12.6 percent of providers considering cost as the biggest flaw.
When it comes to interoperability, the biggest problem for most providers is the fact that most EHR software is proprietary and provides no interoperability features out-of-the-box. “Currently, the burden of EHR interoperability falls on the provider,” says Dr. John Kulin, CEO of The Urgent Care Group, PA, an urgent care center in Manahawkin, NJ. “EHR interfaces are cost-prohibitive to set up and maintain, particularly for a physicians practice or small hospital. You’re asking providers to outlay a ton of money to achieve interoperability with no clear financial incentive for them to do so.”
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The biggest gripe from a clinical workflow perspective is that most EHRs simply don’t mirror the way a physician works. Instead, they force the clinician to change their workflow habits, which is not only painful, but also counterproductive.
“Before adopting an EHR, our physicians dictated their patient notes,” says Joan Brown, practice administrator at Wyoming Cardiopulmonary Services, PC. “This practice was quicker and more efficient for them. Now, our physicians spend more time looking at a computer screen trying to enter all the data required for the EHR. The patient note isn’t nearly as thorough as it was with dictation, and our patients have even commented that more attention is being focused on the computer than on them.”
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All the patient data being collected by EHRs seems to be creating some clinical workflow challenges in its own right. “The EHR requires physicians to capture a ton of information on every patient,” says Dr. A. Thomas McGill, VP of quality and safety and CIO of Butler Health System. “For example, I now spend about 80 percent of my time gathering information for the EHR — a lot of which isn’t even pertinent to my working diagnosis.”
Recommended Fixes To EHR Faults
When it comes to improving EHRs, the recommendations for software improvements basically mirrored the conveyed weaknesses. In other words, 33.9 percent of providers surveyed called for unified standards or open data protocols to be incorporated into EHRs to facilitate interoperability. Another 28.6 percent suggested the technology require fewer clicks and less clinician data entry.
For many, it seemed like voice technology could hold the key to a more satisfying EHR user experience. “If somebody could come up with a software program that would allow physicians to dictate and recognize key phrases and autopopulate discrete data fields in an EHR, that would be a magic bullet,” says Brown.
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For others, simply automating EHR data entry isn’t enough. Technology must also be incorporated that streamlines clinical decision making. “If an EHR could provide me with template-driven, contextual information based on my working diagnosis, that would make me and the rest of our doctors much more efficient,” adds McGill.
All the patient data being collected by EHRs seems to be creating some clinical workflow challenges in its own right. “The EHR requires physicians to capture a ton of information on every patient,” says Dr. A. Thomas McGill, VP of quality and safety and CIO of Butler Health System. “For example, I now spend about 80 percent of my time gathering information for the EHR — a lot of which isn’t even pertinent to my working diagnosis.”
