Although information technology has made great inroads into medical practice, particularly in specialties such as radiology, the promise of a seamless electronic healthcare record (EHR) system is still some distance away. However, forward-looking practitioners willing to be early adopters are embracing EHR systems for cost, efficiency, and quality improvement in their practice.
According to a statement by David Powner, director of information technology (IT) management issues for the Government Accountability Office, the U.S. Department of Healthcare and Human Services (HHS) has found that "only a small number of U.S. healthcare providers have fully adopted health IT due to significant financial, technical, cultural, and legal barriers such as a lack of access to capital, a lack of data standards, and resistance from healthcare providers."
Full adoption of health IT, with data from every specialty and department electronically integrated throughout a facility, is the currently the exception; however, almost all healthcare practices have adopted some level of EHR capability.
The Medical Records Institute of Boston conducted a survey of EHR trends and usage earlier this year and reported that the greatest factors driving the need for these systems were efficiency and convenience to physicians through remote access, and workflow benefits in reducing interruptions from the pharmacy and patients about refills, lab results, and the like.
The survey had the participation of 729 healthcare provider respondents and was broken out into hospital- and nonhospital-based groups for results purposes. Approximately 90% of the survey cohort reported that they were either the final decision-maker in EHR selection or an influencer in the process.
Among the hospital respondents, a need for efficiency, the satisfaction of physicians and clinical employees, and the need to survive and thrive in a more competitive, interconnected world were the top three factors cited as driving EHR adoption. Medical practices also cited a need for efficiency as their top factor, with savings and increased revenue through improved coding and charge capture taking second position, and satisfaction of patients and physicians coming in third.
The survey indicates that most facilities have implemented administrative and financial EHR applications such as billing and accounts receivable, scheduling, and patient appointments. Most groups plan on implementing charge capture or coding, patient eligibility, and an enterprise directory to support multiple facilities in the near future.
On the clinical side, demographics collection has achieved a level of use exceeding 50% among the survey respondents. Remote access by physicians; decision support and alerts; postvisit patient education; and previsit health screening, evaluations, or assessments are the applications that the majority of the cohort plan on implementing.
Of particular interest for specialty practices, remote access to lab results is cited as the most important EHR feature by clinicians, according to 53.3% of the respondents. The capability to access radiology results utilizing healthcare IT is reported by 42.7% of the cohort, with 25% stating that they plan on implementing radiology access within the next four years.
As reimbursement for medical procedures, for the most part, continues to decline across the market, it is no surprise that lack of adequate resources or funding is the primary barrier to implementing EHRs, according to 55.5% of those who participated in the survey. Resistance by medical staff to EHR technology, although high at 31.7%, is on the decline from a similar survey conducted in 2003, which reported that 37.2% of the medical staff did not support the adoption of EHR capabilities.
The Medical Records Institute survey indicates that the healthcare professionals implementing EHR technologies are doing so in a pragmatic manner by first adopting applications that demonstrate direct benefit to their practices, such as administrative and financial capabilities, and then seeking to capitalize on clinical capabilities, such as decision support.
By Jonathan S. Batchelor
AuntMinnie.com contributing writer
September 22, 2006
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