EHR change no guarantee for doc satisfaction

Switching electronic health record systems may improve functionality and increase the chances of achieving Meaningful Use, but it may not make physicians any happier about the systems, according to a new survey in Family Practice Management, a journal of the American Academy of Family Physicians.

The researchers surveyed 305 family physicians who had changed from one EHR to another in the past few years to see why they changed and if the change was worth it. The most common reason for switching was to add needed functionality, followed by the desire to meet Meaningful Use, to increase usability and the need for better support and training.

The systems often increase physicians' administrative burdens rather than decrease them, according to an article in the International Journal of Health Services. And while EHRs have benefits, they are not a panacea, in large part because of issues relating to their inadequate design. 

Fifty-nine percent of those surveyed agreed or strongly agreed that the new EHR was more functional, and 57 percent reported that it helped the physician meet Meaningful Use.

However, only 43 percent said they were happy with the change, and 39 percent said they were happy overall with the new system. Many physicians said the change was a business decision "forced" on them by others. And 81 percent of respondents reported that the time investment in switching was a challenge.

Other major challenges included loss in productivity, loss of data and problems with data migration. Physicians who were involved in the decision to switch were happier than those who were not.

When considering switching EHRs, the authors recommended that physicians conduct a "careful" evaluation before taking any action, and that changing workflow, not software, may be a better solution.  

"[I]f your current EHR just cannot incorporate functionality you need or get you to Meaningful Use, it may be time to switch to a new EHR. On the other hand, if you just want to change because you don't like using your current EHR or consider it a drag on your productivity, the grass may not be greener on the other side," the study's authors wrote.

Many providers have cited a lack of usability as a significant barrier to physician acceptance of the systems. In a study by the RAND Corporation, researchers found most that physicians like the concept of EHRs, but that inadequate design and poor usability provide a "unique and vexing challenge to physician professional satisfaction" in areas such as increased time on data entry, interference with face to face care,  poor health information exchange and more.

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