Electronic Health Records or EHRs are one of the essential solutions to move our health care system into the digital age, yet the conversation still questions, at times, the real value of the electronic system. Regardless, HITECH is incenting the change and backing it up with supporting resources.
Highlighted in this post are two different viewpoints on the state and value of EHRs.
Causing a Stir:
The Archives of Internal Medicine published a report entitled: “Electronic Health Records and Clinical Decision Support: Impact on National Ambulatory Care Quality.” As outlined in iHealthBeat.org:
“…EHR-supported patient visits contributed to a significant improvement in only one of 20 quality of care indices, compared with visits tracked using paper-based records. The one index was the frequency of providing diet counseling for high-risk adults, which occurred in 28.2% of visits in EHR-equipped practices, compared with 19.7% of visits involving paper records.
Researchers also found that adding clinical decision support to EHRs did not significantly increase the quality of care. The only indicator that fared significantly better with clinical decision support software was the indicator not to order electrocardiography tests for low-risk patients, which were avoided in 97.7% of cases in practices using clinical decision support, compared with 93% in practices without that capability.”
In another report – the 2011 National Physicians Survey, about 3,000 physicians were asked questions about their thoughts on healthcare reform and the impact of EHRs. A few statistics:
- 24 percent feel EHRs will have a negative effect on patient care
- Physicians who provide longitudinal patient care and are less procedure-oriented were more positive about EHR adoption
- 65 percent feel that quality of healthcare will deteriorate over the next five years
- 45% of all respondents indicated they did not know what an ACO is
Moving beyond the gloom are a few bright spots on the adoption and use of EHRs. Dr. Blumenthal, the national coordinator for health information technology – ONC, highlighted the progress in several interviews:
- “In surveying hospitals and physicians, we know that 80 percent of hospitals are intending to become meaningful users and 40 percent of physicians have already decided to do that and another 40 percent are undecided… We’re on track: we’ve already had 15,000 physicians and hospitals register for meaningful use payments and that’s in just the two weeks that it has been available.” (Interview with Blumenthal: We are ‘on track’ for meaningful use goals, HealthImaging.com, January 20, 2011)
- “Growth in EHR adoption was strongest among primary care physicians last year, almost 30 percent of whom have now adopted at least a basic EHR. In addition, 41 percent of office-based physicians plan to apply for EHR incentive payments. Of those physicians, 79 percent plan to apply in 2011 or 2012, according to the NCHS [National Center for Health Statistics] findings.” (ONC: 81% of hospitals plan to apply for EHR incentives, CMIO.com, January 13, 2011)
- “Additional survey data from NCHS show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010.” (Survey Press Release, HHS.gov, January 13, 2011)
- Dr. Blumenthal was one of the physicians who made the transition to an EHR. As he stated in April 2010 in a blog entitled Promoting Use of Health IT: Why Be a Meaningful User: “But I am glad I did it, as are 90 percent of all physicians who adopt an EHR, according to a scientific survey published in the New England Journal of Medicine. My EHR made me a better doctor. I really knew what was going on with my patients. I could answer their questions better and more accurately. I made better decisions. I felt more in control.”
We have a long time to go to really understand the value of EHRs, but we are well underway with Stage 1 of Meaningful Use incentives being issued to many hospitals and physician practices during 2011. In my opinion, there is little doubt that we need to move patient information from paper to digits. When we have our patient data in electronic formats, we will then begin to gain more power as patients and will, hopefully, gain the needed efficiencies and effectiveness gains required.
Latest posts by Jon Mertz (see all)
- 5 things I learned in 10 years in healthcare - June 14, 2016
- Millennials on a Mission: Health IT Leader, Jenny Sabol - February 3, 2016
- Giving #HITthanks. Share Your Health IT Gratitude! - November 24, 2014