Take EHR satisfaction reports with a grain of salt


One of the biggest problems for those who use or are considering adopting electronic health records is that the information out there can be very unreliable. It is becoming exceedingly difficult to accurately gauge what's occurring in the industry.

Just look at the spin accompanying some of the findings released this week.

The Centers for Disease Control and Prevention's National Center for Health Statistics reported that more than half of doctors in the United States (55 percent) were using EHRs by the end of 2011. It also found that almost four-fifths (77 percent) of those docs reported that their systems had met the criteria for Meaningful Use.

In the wake of the report--a follow-up analysis of a supplement to the 2011 National Ambulatory Medical Care Survey (NAMCS) of office-based providers--National Coordinator for Health IT Farzad Mostashari posted in a blog post that the physicians' experiences have been "largely positive."

Of course, this is good news for the government, which is committed to the adoption of EHRs and their Meaningful Use.

All that said, while figures in the Physicians' Practice Technology Report, also released this week, were consistent with some of the CDC's findings--the Physician's Practice survey determined, for instance, that a little more than half (54 percent) of practices have adopted EHRs--the report's authors said that such adoption was hovering at that rate. What's more, the report's authors called overall adoption of health IT "slow on the uptick."

Why the disconnect?

The difference likely is in the surveys themselves--how the numbers are massaged--and what the surveyors asked, or didn't ask, the physician respondents. For instance, the CDC, which as a government agency can hardly be called independent, reported the benefits of using EHRs, but none of the drawbacks to EHR adoption--like the time required for implementation, the costs involved and the problems encountered after installation. All of those factors were, however, taken into consideration in the Physicians' Practice report.

Interestingly, the CDC reported that 85 percent of EHR users were "somewhat" or "very satisfied" with their systems. The survey, however, included physicians from HMOs, community health clinics and academic medical centers, not just those in independent practices. Such institutional providers are using EHRs in a higher proportion than their independent counterparts, and likely received more technical and other support for adoption. They also more than likely didn't have to pay for their EHR system, which certainly would impact satisfaction.   

To be fair, while the Physician's Practice survey was completed by just under 1,400 practice-based physicians, administrators and staff, the CDC survey was completed by more than double the number of individuals (3,180 physicians), again, from a wide variety of settings.

Then there's this week's report from KLAS, which found that half of practices that already own an EHR are looking to replace their existing system because they can't get the support they need or the functionality they expected. The report took into consideration findings from more than 300 prospective ambulatory EMR buyers.

Just because there are some obstacles and dissatisfaction with EHRs certainly doesn't mean that providers should avoid them. But what studies can you rely on to help you through the process? Who can you trust?

Perhaps the key is to do additional homework and not rely on one study, consultant, or report. Cast a wide net and evaluate and compare their findings.

And take all of them with a grain of salt. - Marla

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