Only 4 percent of physicians have a fully functional EHR system and 13 percent have a basic one, according to a study in the June 19 online edition of the New England Journal of Medicine.
The survey of 2,758 physicians — authored by David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital and Catherine DesRoches, an assistant in health policy at Massachusetts General — shows that 16 percent of physicians had purchased an EHR but not employed it, while 26 percent planned on buying one within the next two years.
The authors define a fully functional EHR as one that has a broad range of capabilities including order entry and clinical decision support. A basic EHR is one with a minimum set of functionalities such as recording laboratory data and clinical notes, and electronic prescribing.
According to the study, EHR use is much more prevalent among younger physicians, primary care physicians, and physicians in larger practices, hospitals and medical centers, and is more widespread in the Western part of the United States. Two-thirds of physicians without EHRs cited affordability as the reason. Other reasons included finding the right EHR, concern about return on investment, and that the system will become obsolete quickly.
Physicians who use electronic records report being satisfied, with large majorities saying it helped improve the quality of clinical decisions, helped them communicate more effectively with other providers, and facilitated prescription refills and avoidance of medical errors. Having a full electronic record also had positive effects on the delivery of chronic and preventive care, helped doctors avoid problematic medication interactions, and promoted more efficient ordering of critical lab tests, they indicated. One in five physicians expressed reservations about ease of use and reliability of their systems.
According to the authors, further adoption may be enhanced by helping doctors buy an EHR either through loans, incentive programs, or directly paying them, as well as protecting them from personal liability for record tampering by external parties.
For copies of the survey, contact Isha Mehmood.
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