Electronic Health Reporter

Guest post by Scott Parker, Cure MD.

Despite the government doling out billions for the advancement of healthcare information technology (HIT) through the electronic health record (EHR) Medicare and Medicaid incentive programs, the shift toward adoption of EHR has not picked up as rapidly as expected.

A deeper study into the issue reveals that physicians and healthcare providers, who are normally at ease in incorporating cutting edge technology into their work, are facing a plethora of problems because of the government’s incentive programs. A hasty implementation of certified EHR, which were provided by hundreds of vendors, resulted in physicians buying tools that were not optimized to meet a individual user’s needs. As a result, instead of facilitating providers, these tools have had a negative impact on their workflows, decreasing efficiency.

The major problems faced by providers relate to EHR usability and interoperability. According to the Healthcare Information and Management Systems Society (HIMSS), “usability is one of the major factors- possibly the most important factor -hindering widespread adoption of EHRs.”

A survey conducted by American EHR Partners based on data collected from 2010 to 2012 concluded that user satisfaction levels with EHRs are dropping in multiple areas; 33 percent of those surveyed reported they were “very dissatisfied” with their EHR and that their productivity had actually dipped since they started using EHR. In the same survey, it was found that 39 percent of healthcare providers would not recommend their EHR to a colleague in 2012, a statistic that stood at 24 percent in 2009.

These numbers reflect that EHR development still has a long way to go and is relatively immature in its growth cycle. Since there is no “one-size-fits-all” solution for providers’ needs, different healthcare providers will require different interfaces and usability tools. Because of the need for versatility and customization along with the inability of most EHRs to cater to these needs, providers find EHRs confusing and complex and face issues in incorporating them into their workflow.

At the same time, providers are also facing major challenges in health information exchange (HIE) and it is extremely difficult in most cases to transfer and/or share medical information. With grave interoperability problems looming overhead, a huge question mark has been placed on the effective use of EHR in achieving national policy goals.

In this regard, a survey conducted by the Bipartisan Policy Center (BPC) suggested that more than 70 percent of “clinicians surveyed believed that the lack of interoperability and an HIE infrastructure, and the cost associated with both, are major barriers to digital information sharing.” This is despite the fact that in the same survey, a majority of physicians accepted that electronic transmission of medical information will enhance quality of health care.

This brings home important conclusions for both, policy makers and EHR vendors. For the former, this clearly shows that cash-based incentives solely will not, on its own, solve underlying problems in EHR adoption. Therefore, perhaps the Office of National Coordinator (ONC) and Centers for Medicare & Medicaid Services (CMS) ought to combine efforts with vendors to involve physicians and providers in the design and adoption of EHRs nationwide. This will go a long way in evolving EHRs that better fit the needs of specific providers and accomplish effective usage. For vendors, this shows their products need further development and require ease of usability for which end-user feedback is essential.

Scott Parker is a health IT expert who actively contributes to the leading industry forums by writingcontent encompassing current topics such as the EMR, practice management, eRx, patient portal, revenue cycle management, compliance, ICD-10, meaningful use, privacy and security.