EHR Adoption: Lingering Issues Remain for Medical Practices

A recent technology survey published by Physician Practice has a wealth of information about EHR adoption, with some interesting and sobering results.

First, some overall metrics of the survey, to get a sense of its overall scope:

• The survey had 1,291 total respondents.

• The mix of independent and hospital-owned practices was about evenly split. Slightly over half were independent practices, and the remaining ones were hospital- or IDN-owned.

• Most respondents were small groups; roughly one-fourth of were solo practices, with only about 25 percent consisting of 10 or more providers.

• Primary care represented just over one-fourth of respondents, with single- or multi-specialty combining for almost half of practices.

There are dozens of questions and results, but the following are some that seem particularly interesting:

EHR adoption continues to increase - but significantly lags virtually all other industries

The number of practices that state they have fully or partially adopted an EHR appears to have increased from about 53 percent in 2007 to about 77 percent in 2013. However, less than half of the respondents (45.3 percent) report that they have even fully implemented an EHR. This is a significant increase, but in any other industry it would be an absurd number…it would be ludicrous if airlines, hospitality, and banking would still have about one-fourths of its practitioners that have adopted automation and technology. Imagine going to your bank in 2013 and have them manually enter your deposit amount and stamp your passbook with that little rubber stamp thingy that has all the months, days, and years on those nifty little rubber belts.

Mobility is a major differentiator, even for the "haves" versus the "have-nots"

The number of practices whose EHR is accessible via smartphone or tablet is only 50 percent. The remainder can only access their EHR in a traditional full-screen computer. (Presumably this is the subset consisting only of those who have fully or partially implemented an EHR.) Since the overwhelming trend in technology is towards mobile devices, this further shows the massive technology gap that healthcare demonstrates relative to all other industries.

Following the crowd:  The biggest factor in EHR selection

The number one factor in response to the question, "What factors influenced your EHR choice?" was, "What the hospital/other care delivery partners are using." This clearly sounds like a good idea; with over 400 different EHR vendors, the choices are staggering. However, since interoperability between and among systems within different clinics is far from being achieved in reality, it reflects a less strategic focus than the numbers might suggest. In reality, it’s more a function of, "well, if it’s good enough for XYZ, it’s probably good enough for me." As further evidence that this is simply a safety-in-numbers concept, the answer, "Compatibility with our existing technology such as our PM system" was sixth on the list, less than 20 percent of a factor.

EHR implementation is not the nightmare that it is made out to be

Many horror stories abound in the literature - as well as in hallway conversations at medical conferences - about the supposedly massive problems with EHR implementations. Yet slightly over half (51.5 percent) of respondents characterized the experience as "A little bumpy but it could have been worse." The number that chose the highest satisfaction answer - "Smooth sailing. Couldn’t have asked for a much easier process, given the nature of the change." -  at 12.9 percent, was more than doubl those that answered, "Traumatizing. I wouldn’t have wished it on my worst enemy." (6 percent) So those who claim EHR implementations are a potential practice-killer are ignoring the facts, at least the statistics reflected in this study.

In my next blog (on July 16), I'll continue my analysis of the Physicians Practice Technology Survey in terms of what it says about staffing, vendor satisfaction, and much more.