Study: Docs less positive about MU, less ready to adapt to it

Physicians are not as confident about Meaningful Use and not as ready or willing to change their work habits in order to meet the requirements as other clinicians, which can adversely affect the success of electronic health record implementation in ambulatory care settings, according to a new study in BMC Medical Informatics and Decision Making.

The researchers, from the University of North Carolina at Chapel Hill, hypothesized that without readiness to change work practices to demonstrate Meaningful Use of their EHRs, the adoption of the EHR is less likely to succeed. They examined perceptions about Meaningful Use among different providers from 47 ambulatory practices at the University of North Carolina Health Care System.

The study found that only 57.9 percent of physicians were amendable to changing their work habits to adapt to Meaningful Use, compared to 82 percent of advanced practice providers and 83.3 percent of nurses. Physicians also were "significantly" less likely to believe that their department would be able to address implementation problems; only 28.4 percent believed as much, compared to 42.6 percent of advanced practice providers and 47.1 percent of nurses.

The researchers suggested that physicians may be more negative about Meaningful Use because they perceive that the change burden to fall primarily on them, or that Meaningful Use threatens their autonomy by placing constraints on the patient encounter.

They also found that physicians in specialty settings were more likely to report that Meaningful Use diverts attention from other patient care priorities.

"[L]eaders of healthcare organizations should pay attention to the perceptions that providers and clinical staff have about MU appropriateness and management support for MU," the researchers said. "Change management efforts could focus on improving these perceptions if need be as it is feasible that doing so could improve willingness to change practices for MU." 

For instance, the healthcare entity could reduce the burden of changing work practices, communicate the benefits of Meaningful Use to physicians, and adopt policies that incentivize Meaningful Use demonstration.

It's been well documented that EHRs change a practice's workflow and can increase a physician's administrative burdens. The Office of the National Coordinator for Health IT's recent data brief on EHR adoption acknowledges that incentive payments associated with the Meaningful Use program are the primary reason why doctors are transitioning to the systems.

To learn more:
- here's the study (.pdf)