EHRs

Just 4 percent of physicians reported having an “extensive, fully functional” electronic health record (EHR) system, while 13 percent said they have a “basic” system, a national survey published by the New England Journal of Medicine revealed.

EHR systems were more prevalent among physicians who were younger, worked in largeor primary care practices, worked in hospitals or medical centers, and lived inthe Western region of the United States, according to the survey’s results.

Physicians who reported having “fully functional” systems apparentlylike what they’ve seen. Of that small group, 82 percent said the systemhas had a positive effect on the quality of clinical decisions, while 92 percentsaid it improved communication with other providers and 86 percent said it helpedin avoiding medical errors.

A smaller percentage of the “fully functional” group, 72 percent,said an EHR system has improved communication with patients.

Of the 83 percent of respondents who said they did not have EHR systems, 16 percentreported that their practice had purchased but not yet implemented an EHR systemat the time of the survey. An additional 26 percent of respondents said that theirpractice plans to buy an EHR system within the next 2 years.

Not surprisingly, cost was the biggest obstacle to adoption. Among physicianswho did not have access to an EHR system, 66 percent said capital costs were thereason, while 54 percent reported not finding a system that met their needs and44 percent said they were concerned their system would become obsolete sometimeafter purchase.

Rates of EHR system adoption didn’t differ significantly among providersserving a high proportion of minority patients or patients who were uninsuredor receiving Medicaid, according to the survey.

Keys to a successful EHR system implementation, according to an article in the July 4, 2008 issue of Medical Economics, include:

• Getting every department in a large group involved in the roll out;

• Introducing the easiest functions first;

• Scheduling lots of uninterrupted time for employee training.

FP Ben Park of Lebanon, IN, says his practice has gone through six EHR programs since 1979.

"The most important aspect of the implementation is the commitment," says Park. "Yes, it is going to be hard. Yes, there will be times of great frustration. But the bottom line is that, in the end, we are going to use an electronic health record because that is the only effective tool we have to measure and improve the care we deliver.”

The survey of 2,758 physicians was conducted in late 2007 and early 2008. It had a 62 percent response rate. The survey was approved by the institutional review board at Massachusetts General Hospital and by the federal Office of Management and Budget.

The primary differences between what the survey organizers classified as a fully functional system and a basic system were the absence of certain order-entry capabilities and clinical-decision support in the basic system, according to the survey.