Electronic health record adoption by physicians is growing, to judge by the results of a recent survey sponsored by Medscape, a leading website for continuing medical education. The survey of 21,200 physicians across 25 specialties, conducted last spring, found that 74% of them already were using an EHR and that another 8% of them were currently installing or implementing systems.
In 2011, 57% of physicians said they were using an EHR, according to a survey by the Centers for Disease Control and Prevention (CDC). An SK&A telephone poll in January 2012 found that just 46% of doctors had EHRs.
The rapid increase in physician adoption of EHRs this year is directly related to the government's incentives for Meaningful Use of qualified EHRs and the penalties for not showing Meaningful Use, said Leslie Kane, executive editor of Medscape's Business of Medicine division, in an interview with InformationWeek Healthcare. Indeed, the Medscape survey indicates that 44% of the respondents had already attested to Meaningful Use and that 31% expected to within the next year.
In addition, Kane pointed out, peer pressure has had an effect as EHR adoption has reached critical mass. "The number of doctors stonewalling against EHRs has dropped, and people are getting on the bandwagon," she said.
That doesn't mean, however, that physicians are universally happy about the change. Twelve percent of EHR users in the survey were strongly or somewhat against the systems before they adopted them, and 14% felt that way afterwards. Similarly, 62% of users were somewhat or strongly in favor of EHRs before implementing them–a percentage that rose to 67% afterward. The percentage of doctors who were neutral about EHRs fell from 25% before to 19% after.
To Kane, these findings indicate the importance of preparing physicians for EHR implementation. "The message to practices is to get doctors psyched beforehand, because how they feel about it before, they'll feel afterwards."
Twenty-six percent of respondents said that EHR adoption had reduced their productivity, but 15% said their productivity had increased. And while 30% of the doctors said that EHRs had negatively affected their relationships with patients, 36% said those relationships had improved.
Kane attributed much of the differences in the responses about productivity to differences in the amount of training that physicians received from vendors or hospitals. Those who received good training and support, she said, tend to adapt better and lose less productivity.
Based on comments from some respondents, many physicians find EHRs reduce their eye contact with patients. There are proven methods of avoiding this problem, Kane said.
Nearly a quarter of respondents found that EHRs increased efficiency, but only 6% said they helped increase practice revenue, and 5% said they lowered costs. So it does not appear that many doctors earned more as a result of using EHRs.
The majority of respondents did not know how much their systems cost. That may be because nearly half of them were in groups of 11 or more doctors. Among those who did know, most respondents with practice-based systems said they cost $10,000-$35,000 per physician. Monthly charges for Web-based EHRs ranged from under $300 to more than $700 per provider per month.
The most widely used EHRs, in order, were Epic, Allscripts, Cerner, GE Centricity, eClinicalWorks, NextGen, and Meditech. But the top-ranked EHRs among users were quite different: Amazing Charts, Practice Fusion, VA-CPRS (the Department of Veterans Affair's VistA EHR), Medent, e-MDs, Epic, athenahealth, eClinicalWorks, and Sage, in descending order.
