Physicians identify primary concern with health IT

AMA Wire
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When it comes to issues with health IT, physicians overwhelmingly point to one problem. Here’s what physicians think about electronic health record (EHR) systems.

A recent survey (login required) by Physicians Practice found that physicians say EHR adoption, implementation and interoperability are their most pressing technology problem.

While about 53 percent of the more than 1,400 physicians who responded to the survey said they did have a fully implemented EHR system in their practices, about 20 percent said they didn’t yet have one. The main reasons for not having an EHR system were related to cost or the lack of products available to meet their needs, according to the survey. Another 17 percent said they used an EHR system selected by their parent hospital or corporation.

Roughly one-third of respondents said their EHR system has made practice work flow less efficient, while nearly one-half said the technology has made it more efficient.

The survey results echo findings from the AMA’s 2013 study, conducted in partnership with the RAND Corporation, which found EHR systems to be a major contributor to physicians’ professional dissatisfaction. The physicians surveyed for the AMA study expressed concern that current technology requires physicians to spend too much time on clerical work, putting up barriers to providing high-quality care.

The AMA study also revealed that EHRs were more costly than anticipated and didn’t provide the technology needed to interact with other systems, causing difficulties in transmitting patient information.

About 16 percent of physicians surveyed by Physicians Practice indicated the lack of EHR interoperability was their most pressing issue, and another 13 percent cited costs to implement the systems as a problem. About one-quarter of physicians that did not have an EHR said they didn’t have the technology because it was too expensive. Nearly two-thirds said they have not seen a return on investment.

According to Physicians Practice, EHR use is seeing a slow but steady trend upward. In 2010, 48 percent of responding practices had implemented an EHR. By 2014, that number climbed to 70 percent.

As part of its Professional Satisfaction and Practice Sustainability initiative, the AMA is developing a set of priorities and recommendations to improve the usability of EHR systems, identifying opportunities to achieve these improvements, and determining a research agenda to advance the evidence base for increasing usability.

The AMA is taking physician issues and recommendations directly to EHR vendors to encourage them to make the necessary changes in their future product designs and is working with the Electronic Health Records Association on these efforts.

Read more about how the AMA is working to make EHR systems less burdensome and more beneficial for physicians and their patients.

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I currently use EPIC and find it cumbersome to wade through the program. It is not intuitive. Why would a programmer not tab the screen like a chart so practitioners can flip through the program like we have done with paper charts for years? has anyone ever looked at a printout of an epic chart? Completely unreadable. SOme of the information like who entered the ordered, did the labtest, requested the test could be backgrounded to make it more readable.
Electronic records can be a valuable tool for data retrieval on a National scale. However data is misleading if the input is sloppy and unreliable picking any answer for any question not directly queried. Always a problem with long shopping lists of information.
There are many troublesome issues with the EHR, many of which were anticipated and many of which were not. If I could make only one change, it would be that every EHR in the country had the same look and feel, the same commands, regardless of the Vendor. Every Medical Student and every Nursing Student would start with this same core medical record EHR from the day they entered training. Now, for the Vendors who want to convince you that their version is better than someone else's - each EHR would have an inner core and an outer shell. The outer shell would have all the bells and whistles they want to put in so that they can convince you to buy their program over their competitor's. However the inner core, which would include all of the basics necessary to deal with a patient, including "Meaningful Use" data, would be identical, even to the screen shots. You could sit down at any computer in any health care facility and get the basic job done. When they teach you to fly, they sit you down in a plane like a Cessna 150, with limited instrumentation and capability. You can however learn to fly it well enough to move on to a plane with more functionality. You don't teach someone how to fly for the first time by sitting them down in an F-22.........................
I agree with dorkinh but would take it a step further. Consistency is a must, but there's no reason we shouldn't have ultra-deep professional profiles that dictate to the EHR what data we need and how we want to see it. Each of us in health care already has an incredible volume of data defining who we are and what we do as professionals (education, training, schedules, patient populations, CME, etc.), and while each internist, nurse practitioner or radiologist has similar work responsibilities and preferences, they are by no means identical. We need a consistent experience with EHRs, but we also need this experience to be tailored to how we perform best - for if we perform at our best, everyone wins. This should be our ultimate goal ... and it's very doable.
I am not sure the the current and recent past iterations of EHRs were ready for prime time. They were poorly planned, oversold and driven by huge government windfalls for for vendors. Then there was the Medicare mandate with which physician's arms were twisted. The early adopters will likely require expensive updates or even possibly entirely new systems. Vendors will come and go. The systems continue in trial and error mode. Somehow, much of this could have been avoided, and a more useful and intuitive niche could have been designed to maximize the usefulness of this tool. Many tools have been introduced to improve the quality and efficiency of patient care. The EHR is only a potential additional tool that has been oversold as a panacea.
Our latest Viewpoints is by our chair of the AMA Board of Trustees, Dr. McAneny, discussing a number of these sorts of limitations in EHR products, and what she is prepared to tell her EHR vendor when she sits down for a "user group" discussion. <br/> <br/> Link to the Viewpoint: <a href=""></a>
I am a great fan of digitizing all data. I have very little paper in my home as a general citizen of society. All my records are scanned and ordered into folders on my Mac but can easily be read on any machine. That being said, EHR is an incredible tool if only competent programmers could design it. When you offer multi-million dollar bid packages to corporations, they will mete out EHR software that costs the least to produce by incompetent/unqualified programmers so they can make the most profit. When I walk into a doctor's office and see racks of paper records, I cringe. I know that all that info could be digitized. I have seen *one* doc. (he is a plastic surgeon) here in New York City who does use all in-house digital record keeping. They had it all at a server with files that were accessed via an iOS (iPad) app. That was incredible and that doctor was an older man in his 50s so it's not as if it's only for the new generation of tech-kiddies.
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Feb 23, 2017
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