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Physician outcry on EHR functionality, cost will shake the health information technology sector
Why a national outcry from physicians on EHR cost, functionality, and customer satisfaction will shake the health information technology sector
Despite the government’s bribe of nearly $27 billion to digitize patient records, nearly 70% of physicians say electronic health record (EHR) systems have not been worth it. It’s a sobering statistic backed by newly released data from marketing and research firm MPI Group and Medical Economics that suggest nearly two-thirds of doctors would not purchase their current EHR system again because of poor functionality and high costs.
In a surprise finding, nearly 45% of physicians from the national survey report spending more than $100,000 on an EHR. About 77% of the largest practices spent nearly $200,000 on their systems.
While physicians can receive $44,000 through the Medicare EHR Meaningful Use (MU) incentive program, and $63,750 through Medicaid’s MU program, some physicians say it’s not nearly enough to cover the increasing costs of implementation, training, annual licensing fees, hardware and associated services. But the most dramatic unanticipated costs were associated with the need to increase staff, coupled with a loss in physician productivity.
“We used to see 32 patients a day with one tech, and now we struggle to see 24 patients a day with four techs. And we provide worse care,” said one survey respondent.
While some physicians cited benefits of accessing patient data, availability of practice metrics, and e-prescribing conveniences for patients, most physicians do not believe these systems come close to creating new efficiencies or sharing data with multiple providers or improving patient care.
In fact, when doctors were asked if their EHR investment was worth the effort, resources and cost, “no” was the reply given by nearly 79% of respondents in practices with more than 10 physicians.
Medical Economics’ survey results, based on responses from nearly 1,000 physicians, were corroborated by the findings of a January 2013 RAND Corp. study, detailed in Health Affairs, The New York Times, USA Today, and other national media organizations, criticizing the usability and interconnectedness of current EHR systems.
“The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place,” says Art Kellermann, MD, MPH, the study’s senior author and the Paul O’Neill Alcoa Chair in Policy Analysis at RAND.
Another 2013 RAND report, titled “Physician Professional Satisfaction and their Implications for Patient Care,” concludes that frustrations related to EHRs are negatively influencing physician attitudes about their careers.
“Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction,” the report says.
The most recent data from MPI Group and Medical Economics not only corroborates these physician sentiments related to EHRs, but calls on software developers to build solutions that help physicians improve
patient care, not obstruct it.
Closer look at the results
Here are other key findings from the national survey:
- 73% of the largest practices would not purchase their current EHR system. The data show that 66% of internal medicine specialists would not purchase their current system. About 60% of respondents in family medicine would also make another EHR choice.
- 67% of physicians dislike the functionality of their EHR systems.
- Nearly half of physicians believe the cost of these systems is too high.
- 45% of respondents say patient care is worse since implementing an EHR. Nearly 23% of internists say patient care is significantly worse.
- 65% of respondents say their EHR systems result in financial losses for the practice. About 43% of internists and other specialists/subspecialists outside of primary care characterized the losses as significant.
- About 69% of respondents said that coordination of care with hospitals has not improved.
- Nearly 38% of respondents doubt their system will be viable in five years.
- 74% of respondents believe their vendors will be in business over the next 5 years.
Major Disconnect
The Medical Economics survey was conducted to gauge physician attitudes about EHRs and benchmark data gathered during a separate and novel 2-year EHR Best Practices Study of 29 U.S. physicians in independent practices (nearly all were in solo practice).
While this 2-year study concluded at the end of 2013, some of the same physician attitudes and frustrations related to the implementation and use of EHRs were documented in the national survey. Common frustrations cited by physicians in both projects included a decrease in patient visits, reports of efficiency declines, and unanticipated costs associated with implementing and using EHR systems.
The national survey underscores the major disconnect between the current state of EHR software and the needs of physicians.
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