Another Day, Another EHR Survey

Another day, another EHR survey, and once again it’s about the security of information contained in electronic health records.

Apparently, according to this latest survey, more needs to be done to educate patient consumers of the value of the healthcare technology they encounter in their physician’s offices even though more than 50 percent of respondents said they feel EHRs are better than paper charts. Specifically, in this survey patients feel their personal information contained in the EHR is vulnerable to security breaches or hackers.

The data captured in this survey is not surprising, nor is it anything new. In fact, the following statement came from an April 2011 survey I administered for a major healthcare software vendor and announced to the press:

“While both physicians and patients believe that EHR will help improve the quality of healthcare, both groups have concerns about privacy and the security of EHR.” – April 26, 2011.

Though many people think the burden of educating the public about the benefit of EHRs should be placed on physicians, I disagree with this stance.

Physicians, frankly, are consumers of EHRs, just as patients are. It’s an unfair burden to put a group of consumers in the position of advocates for products they pay to use. In what other commercial industry do the manufacturers and retailers of products leave the education of the product to consumer? Correct me if I’m wrong, but I can’t think of any.

The burden of educating consumers about the value and importance of EHRs should fall to the EHR vendors. After all, the vendors are the experts of their products’ capabilities, not the physicians. Automatically electing physicians into this role is unfair.

When I represented an EHR vendor, we brought our message to physicians and patients. Get patients to realize the value of EHRs and you drive them to persuade their physicians to adopt the systems. Our stance meant we held ourselves responsible for educating the market about our EHRs’ capabilities. We didn’t feel that it was right to put our physician clients in the position of becoming product advocates unless they wanted to be. Advocating our products was our job.

As patients become more familiar with EHRs, they will fear them less, just as happened with online banking and shopping. Familiarity and comfort with these systems have changed and so have consumers’ perception of them; the same will ultimately happen for EHRs.

Misleading EHR Headlines Reign (and Remain)

According to the latest Centers for Disease Control and Preventions’ National Center for Health Statistics survey of 2011 EHR adoption trends, released on July 17, use of EHRs is up to 55 percent of practicing physicians. That’s a 5 percent increase from 2010, also according to a CDC survey.

The survey of 3,180 physicians was funded by the Health and Human Services Department’s Office of the National Coordinator for Health Information Technology. More than 55 percent of all physicians use and EHR (and more than 86 percent of physicians in practices with 11 or more physicians use an EHR). Physicians also value their current EHRs more compared to past iterations of the systems and, finally, respondents said the care they provide to patients is better than in the past because of the EHRs.

Problem: there’s no data in the survey to support this final claim.

Obviously, EHRs are intended to improve care, whether at the individual level or at the practice level. However, physicians accessing patient data through the records should be tracked and made quantifiable.

Practices using EHRs have the power to change lives for the better, manage care and ensure proper care is provided throughout a patient’s care plan. Practices can and should track how care initiatives have changed with the implementation of an electronic health record and how their patient populations’ health benefits.

Simply stating that patient care has improved when a practice uses an EHR is an immeasurable statement. Innovative practices find ways to track these outcomes whether it means there are fewer chronic conditions among their patients or that their patient populations’ life expectancy actually increased over a period of time (as can be measured and in some cases has been done).

The ONC needs to do more to encourage physicians to move beyond meaningful use stimulus, which is driving the increased use of EHRs. And while the data collected from surveys such as this are important, as I continue to say, they don’t tell the whole story of how technology can improve healthcare.

And throwaway statements indicating immeasurable “facts” does nothing more than generate misleading headlines.

Meaningful Use: More than Meaningful Work

The numbers don’t lie. The meaningful use incentive program is working, at least as far as awarding stimulus funds is concerned. The incentive program awarded “761 hospitals and 56,585 professionals a total of approximately $2.3 billion for 2011; $1.3 billion to hospitals and $1 billion to eligible professionals,” according to Healthcare IT News.

The median payment to hospitals was $1.7 million. According to the same publication, in a recent interview with National Coordinator for Health Information Technology, Farzad Mostashari, his top concern is how hospitals and practices embrace the spirit of the rule and use their technology to successfully engage patients.

From dollars to sense. Without patient engagement, meaningful use is meaningless. Without applying the patient information to the population served and working to improve outcomes and offering education and guidance – perhaps creating support groups for smokers wanting to quit or practice-sponsored nutrition plans for obese and diabetic populations – to patients, meaningful use is nothing more than a government-run plan to collect information about its citizen’s health.

Incentives aside, healthcare providers should wish to do no harm and use the information available to fully commit to embracing change through the technology and data available and do what they do best: care for and help provide health education to their patients, their customers.

In other words, to borrow a line from Mostashari, “If you treat meaningful use as work, you won’t get much out of it.”

At the Heart of Healthcare

We read the data and follow the numbers. Facts don’t lie. Technology can, and does, help improve health outcomes. People’s lives can be improved. Trends can be found and issues addressed.

It’s much less common, though, to hear about how these devices, this technology – electronic health records, for example – are used at the care level in the practice or at the hospital.

Not necessarily the “thought leaders” in the industry, doctors and administrators down the street use this technology to build more efficient business, grow practices and create jobs. The technology allows practices to accommodate the increased number of patients that can be seen each day because a practice management system helps streamline operations so succinctly.

In another world, in a land where the term “thought leaders” is not known, a physician toils her way through an impoverished, uninsured community providing education and ensuring her chronically ill patients are receiving the care they need when they need it, even if she’s conducting house calls and working seven days a week to meet the community’s need for healthcare. How she uses or doesn’t use her technology affects lives. How? You’ll find out soon.

Healthcare technology allows worlds to merge. Distances between providers and their patients are reduced to nothing more than access to a connected device and a Skype account.

But promises delivered are not always dividends gained. Along with the highs, there have been lows. The technology still is not perfect, but for all problems there are typically workarounds.

And while questions will always remain, and thought leaders, government officials and vendor leaders convene to help make things more meaningful, every day folks will continue to run every day practices in every day areas of the world, with or without the help of their technology and technology partners.

Their stories and more – views, observations and opinions — are here at Electronic Health Reporter: at the heart of healthcare, where you live.