If you’re like me and spend most of your day in front of the computer, and can barely function in the office when the internet goes down, then the adoption of electronic health records (EHRs) seems like an absolute no-brainer. In fact, you probably wouldn’t believe that some docs still rely on scribbled notes and paper charts — and hopefully you haven’t had to deal with pushing all that paper around yourself for something as simple as outpatient eye surgery.
But a new study out this week from the Annals of Health shows that computerized systems for managing patient records are still not widespread, with fewer than one half of respondents reporting the use of computerized systems for any of the patient population management tasks included in the survey. While the study did find that the number of physicians using computer records is rising and is up 34 percent from 2011, only 9.8% of the over 1800 doctors surveyed met meaningful use criteria.
I don’t doubt that many EHR systems are not as slick as your average smart phone or tablet, but still, the rate of adoption seems low. There are many roadblocks to adoption, each worthy of their own post, including interoperability, cost and training. But ultimately widespread use of EHRs should – in theory – improve patient care and cut healthcare costs.
According to Bloomberg, since 2009 the Obama administration has spent about $15 billion to help doctors and hospitals adopt EHRs, fueling major growth for vendors. But amid some loud complaints that systems are hard to use and don’t share information easily, the administration recently said it was considering new regulations.
Here in Massachusetts a lot of feathers are being ruffled over the EHR policies. Just last week Howard Zwerling, an MA based MD (and president of EHR vendor ComChart) wrote a widely shared post on The Healthcare Blog about legislation that requires Massachusetts doctors to show proficient use of EHRs to meet the federal meaningful use criteria or they risk losing their medical licenses in 2015.
Seems reasonable, right? EHRs are a definite win for patients in many respects, but in Dr. Zwerling’s “open letter to Massachusetts physicians,” he points out that the practice of medicine has become increasingly difficult as a result of external mandates which specify everything from which medicines can be prescribed, to which radiology tests can be ordered, to how many days patients are allowed to remain in the hospital. Zwerling writes, “Now, the politicians intend to tell physicians which software they must use in their office and which EMR options must be utilized during the office visit.”
But perhaps hardline legislation is what is needed to push doctors to invest the money and time, and endure the annoyance of learning to use these systems. In an editorial accompanying Annals of Health study, Ross Koppel, a sociologist at the University of Pennsylvania in Philadelphia, wrote that the survey shows that the federal government needs to set higher standards for vendors.
Cardiologist David Mokotoff echoes this sentiment in a recent post on Kevin MD, noting that most systems were “initially built for electronic billing. So for coding purposes, they work just fine. But user friendly clinical recording of data often seems like an afterthought.”
There are no quick fixes for the squeaky wheel that is the EHR, but hopefully the ever increasing amount of quantitative and qualitative data on the subject will push vendors in the direction or better, more user friendly products soon.