health records (EHRs) continue to present challenges to the health care community, according to a study released today by the Medical Group Management Association (MGMA). The findings reflect 4,588 valid online responses from a wide variety of health care organizations, including medical group practices representing about 120,000 physicians.
While 80.1% of medical practices that have already adopted an EHR said they intend to participate in the EHR Meaningful Use incentives available through the Health Information Technology For Economic and Clinical Healt (HITECH) Act, only 13.6% indicated that they are currently able to meet all 15 core criteria for eligibility to receive incentive payments. The study reveals marked interest, among respondents that currently use paper medical records, in qualifying for EHR incentives, with 28.8% noting that they are in the process of selecting an EHR system. Of respondents in this segment, 75.2% said they also plan to participate in the HITECH incentive program.
Moreover, nearly 72% of EHR owners claimed they are satisfied with their overall system. However, just 26.5% reported that physician productivity had increased after EHR adoption, while 30.6% said it had decreased and 42.9% claimed there was no change in productivity after implementation. Of the 20.7% of EHR users who said that they had optimized their EHR since implementation, 41.1% reported that productivity had increased,16.5% indicated that productivity had decreased, and 42.4% reported that there was no change in productivity. More than one in three (38.4%) of all EHR users said total practice operating costs had increased following EHR implementation, while 25.9% said costs decreased and 35.7% reported no change in cost. Of those respondents that have optimized their EHR since implementation, 26.8% percent said total practice operating costs had increased, while 39.7 percent said costs had decreased and 33.5 percent cited no change in costs.
Additionally, of practitioners who still use paper records, more than 78% expressed fear that there would be a "significant" to "very significant" loss of provider productivity during implementation, and 67.4% had similar concerns about the loss of physician productivity after the EHR transition period. Practitioners in this category also described the other “significant” to “very significant” barriers to EHR adoption as “insufficient capital resources to invest in an EHR” (71.7%) and “insufficient expected return on investment” (56.9%).
According to the study, practice ownership influences EHR implementation and optimization. Interestingly, independent medical practices appeared more likely to have a fully implemented and optimized EHR than their peers owned by hospital systems. “Hospital-based practices have access to information resources of their parent health system, which would normally imply that these practices would be further along toward optimization,” says MGMA Innovation and Research Vice President David Gans, MSHA, FACMPE, who directed the research. “However, integrated systems are much more complex environments than independent physician practices and their information systems often have to encompass both in-patient and physician components. The added complexity, combined with the geographic dispersion of most hospital-based physician practices, has hindered the advancement.”
One of the hurdles in optimizing any new technology is adequately training new users, Gans states. More than half of respondents (53.2%) conceded that they either "mildly" or "severely" under-allocated the training time needed during the implementation of their EHR systems.