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    Physician outcry on EHR functionality, cost will shake the health information technology sector


    Despite the government’s bribe of nearly $27 billion to digitize patient records, nearly 70% of physicians say electronic health record (EHR) systems have not been worth it. It’s a sobering statistic backed by newly released data from marketing and research firm MPI Group and Medical Economics that suggest nearly two-thirds of doctors would not purchase their current EHR system again because of poor functionality and high costs.




    Click here to view a slideshow of the charts and data tables from Medical Economics' exclusive EHR survey




    In a surprise finding, nearly 45% of physicians from the national survey report spending more than $100,000 on an EHR. About 77% of the largest practices spent nearly $200,000 on their systems. 

    While physicians can receive $44,000 through the Medicare EHR Meaningful Use (MU) incentive program, and $63,750 through Medicaid’s MU program, some physicians say it’s not nearly enough to cover the increasing costs of implementation, training, annual licensing fees, hardware and associated services. But the most dramatic unanticipated costs were associated with the need to increase staff, coupled with a loss in physician productivity.

    “We used to see 32 patients a day with one tech, and now we struggle to see 24 patients a day with four techs. And we provide worse care,” said one survey respondent.

    While some physicians cited benefits of accessing patient data, availability of practice metrics, and e-prescribing conveniences for patients, most physicians do not believe these systems come close to creating new efficiencies or sharing data with multiple providers or improving patient care.

    In fact, when doctors were asked if their EHR investment was worth the effort, resources and cost, “no” was the reply given by nearly 79% of respondents in practices with more than 10 physicians.

    Medical Economics’ survey results, based on responses from nearly 1,000 physicians, were corroborated by the findings of a January 2013 RAND Corp. study, detailed in Health Affairs, The New York Times, USA Today, and other national media organizations, criticizing the usability and interconnectedness of current EHR systems.

    “The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place,” says  Art Kellermann, MD, MPH, the study’s senior author and the Paul O’Neill Alcoa Chair in Policy Analysis at RAND.

    Another 2013 RAND report, titled “Physician Professional Satisfaction and their Implications for Patient Care,” concludes that frustrations related to EHRs are negatively influencing physician attitudes about their careers. 

    “Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction,” the report says.


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    • brittney.sofia@gmail.com
      While some doctors cited benefits of accessing patient data availability metrics practice and conveniences of electronic prescribing for patients 70-411 Dumps most doctors do not believe that these systems are close to the creation of new efficiencies for data exchange with multiple vendors or improve patient care.window server 2012 Dumps
    • Anonymous
      It’s too bad. Members of Congress have before them a model that has been proven to be effective in controlling costs – a single payer national health program or “Improved Medicare for All.” If we had such a system in place then other improvements such as a health information technology system (HIT) could be developed in a coordinated manner that would better serve patients and their physicians.
    • NatashaBache
      Promotion of health, prevention of illness, curative and rehabilatative are the important functions of a health practitioner. This involves health education, prevention of contamination as well as teamwork of the healthcare team. Do you fall to the trap of assuming that your sole purpose in life is to be useful? It doesn’t matter what you do or where you work – everyone is looking for ways to be more productive on the job. Discovering your personal bliss may include accomplishment, but the full, balanced scope of your existence may include times where being lazy is just as appealing.
    • DavidReinertson
      Pleased to see that the anti-government doctors here feel comfortable protesting the mandatory nature of the EMR. Since I'm more pro-government, I would say that most of the pressure is coming from the industry, however. My president is just continuing the well-intentioned government push for standardization, for obvious reasons. Why is the Internet so popular that you and I go online for fun, while EMRs need to be mandated? The difference; the reason why EMRs have failed to improve communication or save labor while Al Gore's Internet has succeeded at both, stems from an initial design decision. The Internet (TCP/IP) protocols were intended to be "as simple as possible, but no simpler", so that widely different communicators could implement them. EMRs, in contrast, are tasked with building in every complication demanded by a user, where a user is a CEO, or proprietor, or regulatory agency, or risk manager, or payor, or the EMR company itself.
      Linguistically, the form is inseparable from the message. I think of EMR forms and, for instance, the English I'm typing into this HTML form as two different languages. One is heavily specified in advance, while the other is very flexible and expressive. A well-written English MD note will look very different depending on the patient, the problem, etc. An EMR file, in contrast, looks like a compromise between many different agencies, but each patient's chart looks pretty much the same as any other. It's as if a surgeon's scalpel was built with ten handles - one for each stakeholder. The cut would depend more on the balance of power and degree of cooperation between the team of handlers than on the particular anatomy of the patient.
    • Dr. Adams
      The electronic medical record is unproductive torture. Government control of the practice of medicine, such as the financial imperative to accept the electronic medical record, is bad for patient care and is abuse of the physician. It is interference with the care of an individual patient; it is interference with the care of the population of patients, it is theft of professional time and personal property of the physician. That is my opinion!
    • Dr. yourskeptic
      staying with paper and taking the fines. The better volume more than makes up for it.
    • Anonymous
      I am staying with paper also, my patients love it and I don't care about any fines. At least I can look my patients in the eyes and not at a computer while I'm typing. I'm also done with Board exams, its nothing more than further bureaucracy. I don't need it for anything I do and the questions they submit are outdated and stupid. MAO inhibitors, has anyone prescribed them in the last 20 years? Also, CME programs that charge physicians 2-3 times as much as the NP sits next to you for the same credits. If we all banded together and took back our profession , we could be FREE and powerful once again.
    • Dr. yourskeptic
    • Sushantsaraswat
      Hi Daniel, you are correct in pointing out that the medical fraternity is far from satisfied when it comes to EHR implementation. For EHRs to be really transformational , one needs an system which is flexible, interoperable and can adapt to changing compliance requirements easily. Following up on this, I came across and registered for a webinar on Healthcare IT: Role of EDI in Affordable Care Act Reforms, it looks a promising one http://j.mp/1b4qJC3
    • Anonymous
      I think of EMR forms and, for instance, the English I'm typing into this HTML form as two different languages. One is heavily specified in advance, while the other is very flexible and expressive. A well-written English MD note will look very different depending on the patient, the problem, etc. An EMR file, in contrast, looks like a compromise between many different agencies, but each patient's chart looks pretty much the same as any other. It's as if a surgeon's scalpel was built with ten handles - one for each stakeholder . http://tinyurl.com/nqokhq6
    • Dr. alan shiener
      It has ruined my life also because I am compulsively trying to do it right and accurately. It forces me and others to retire early in 1 year instead of 5.
    • Anonymous
      I really had high hopes for EMR's initially. Used one on an Army base and just figured it was inefficient because, well, it's the Army and has to be useful for everyone and around the world. Then worked in a medium sized group practice that was well known for lowest cost hardware and figured it was just them. I figured the ridiculously long hours were just me being inefficient. I'm really dismayed to see it's everyone and everywhere. Feeling a little hopeless. Taking time off from practice right now. Might be early retirement, which would really be a loss since I had a really great rapport with my patients, but couldn't take the hours it took to document properly and refuse to do a half-baked job. Need to regroup. Maybe the answer is really just going solo and chucking the EMR.
    • Anonymous
      This was pretty much my experience with EHR's at my Air Force Clinic. Added another 1 to 2 hrs to my day. I worked the longer hours rather than cut back on the number of patients that I treated. The financial rigors of private practice create the same scenario. They are certainly not paying us anymore to hire the scribes and ancillary staff needed to make EHR's work. In order to make a decent living, my free time/quality of life suffers. Solution: large group practices to share the overhead (Kaiser is a good example). Future: loss of the private/solo practitioner. Impersonal factory medicine is the future. Historical example: The old Soviet Union and Eastern Bloc countries.
    • Anonymous
      Big shocker right?! The healthcare.gov rollout is the perfect model for how related policy decisions have been implemented (botched), decisions on vendors(handouts, nepotism, cronyism), who gets what and why. In other words, meaningful use isn't about innovation or improvement. It's a way to turn the tables on who has their hands, really has their hands in the healthcare pot. Remember at 20% of GDP there is ton of money flowing through the veins (so why not reroute more of the pipeline through the district) and the more problems one creates the more solutions can be procured. Get it? Gotta love whopper size GOVT. I'm not a Doctor btw, yet I've seen how "the electricians" wire up the establishment and sickened by how the large government "fad" has devoured the virtuous intentions of the "sheeople" who graze with their heads down. I still remain passionate to do my part and change (what a funny word that's become) what I can, and if it means encouraging the medical profession to get their voice back and not feel overrun by bigbro than great. Many of the doctors I've had the opportunity to work with or be treated by are incredible people who have sacrificed a lot, be it time, freedom, money, etc. to make a difference in people's lives - because improving health for people was an initial purpose for most in the profession and not because it sounded sexy at the Passover table. Conflicts are reality across all walks. I've never met a doctor who didn't use his deepest clinical judgement to affect an outcome. But I'd rather take the chance that they might have a little industry support to help him/her not worry about making ends meet than some chucklehead bureaucrat who never went to medical school and could be about as engaging as a piece of ceramic tile. One last thing: now I may not love Jesus as much as he does, but a highly respected Neurosurgeon named Ben Carson gave this speech last year in front of the Prez, on a national platform and as of October 2013, he has been targeted by a certain govt. agency- God bless America: http://www.youtube.com/watch?v=KpiryahOspY
    • Anonymous
      Our EHR is literally ruining my life - personal and professional. It has eaten up the very small amount of free time that I have and has not helped with patient care. In fact, except for the ease of e-prescribing, I believe it impacts patient care in a very negative way.