Survey: EHR adoption does not ensure better population management
Even as an increasing number of physicians report adopting a basic EHR system, a national survey shows only a small minority of physicians are able to meet Meaningful Use (MU) criteria or use EHRs to manage patient populations, according to research published in the June 4 issue of the Annals of Internal Medicine.
Forty percent of the 1,820 primary care physicians and specialists surveyed between October 2011 and March 2012 reported having a basic EHR; however only one in ten physicians were able to use their systems to meet MU criteria. Half of those meeting MU criteria reported it was difficult to meet at least some criteria, in particular generation of lists of patients overdue for care.
“Results support the growing evidence that using the basic data input capabilities of an EHR does not translate into the greater opportunity that these technologies promise,” Catherine M. DesRoches, DrPH, Mathematica Policy Research and colleagues wrote.
The survey—developed by a project team including National Health IT Coordinator Farzad Mostashari, MD, ScM, and former National Health IT Coordinator David Blumenthal, MD—looked at 11 of 15 core requirements of Stage 1 MU. Of physicians meeting the majority of required functions, 41.6 percent could electronically exchange data with physicians outside of their practice, 40.8 percent could not generate quality metrics and 36.2 percent could not provide patients with an after-visit summary.
The survey also found that use of computerized systems for patient panel management and quality reporting was not widespread. “Physicians with EHRs that meet our MU standard report that population management tasks are easy to do at much higher rates than those with less comprehensive systems; however, substantial proportions still reported that these tasks are difficult,” according to the study.
About half of physicians with computerized systems reported difficulty in generating lists of patients by laboratory result, lists of patients who were overdue for care, and reports on quality of care and track referrals, the research found.
“Using EHRs as simple replacements for the paper record will not result in the gains in quality and efficiency or the reductions in cost that EHRs have the potential to achieve. On the other hand, when physicians and others can use and take advantage of the full scope of the EHR’s functionalities, they may be more likely to improve the quality, efficiency, and patient-centeredness of the care they deliver,” DesRoches et al concluded.
They recommended more research on usability and optimal implementation of EHRs.