EHRs could use an infusion of mobile technology

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of our nation's health IT efforts. ONC is actively supporting the adoption of health IT and the promotion of nationwide health information exchange in order to greatly improve our healthcare system. Creating policies and financial incentives for practices that use electronic health records (EHRs) based on government guidelines that promote certain technologies is one thing. But, what about mHealth?

For now, at least, mobile healthcare appears to be an afterthought. It's clear that EHR adoption is the first and foremost priority at ONC, rather than getting doctors to use apps on mobile devices such as tablets and smartphones. Not surprisingly, the "Meaningful Use" rules for Stages 1 and 2 that ONC helped to define with their partners at the Centers for Medicare & Medicaid Services are primarily concerned with EHR implementation. In fact, in the Meaningful Use Stage 2 rules published in August 2012 the word "mobile" is mentioned only once in the entire document. 

At a time when ONC, the Federal Communications Commission and the Food and Drug Administration are seeking broad input from the healthcare and information technology industries on how the federal government should regulate health IT, these agencies would do well to understand that ultimately satisfaction and usability will drive EHR growth, not some pie-in-the-sky talk about the importance of EHRs for improving healthcare delivery. As one observer recently noted in a comment posted on the FierceMobileHealthcare site: "Before Meaningful Use payments to physicians you couldn't give these systems away."

Nevertheless, even with government incentives, it's been a tough road for EHR acceptance. At the 2013 HIMSS Conference, the American College of Physicians and AmericanEHR Partners released survey results showing that satisfaction and usability ratings for certified EHRs have decreased since 2010 among clinicians across a range of indicators. Overall, user satisfaction fell 12 percent from 2010 to 2012, while users who are "very dissatisfied" increased 10 percent during the same time period. This is precisely where mobile technology might be able to help.

According to national survey results released May 30 by Black Book Rankings, an overwhelming majority of doctors view mobile EHR applications as critical to providing anywhere, anytime access to patient information through smartphones and tablets. Black Book describes this as a "meteoric trend" towards mobile EHR apps, particularly iPad apps. "As thousands of physician practices are opting to dump ineffective EHR systems, and others still scramble to select a first vendor, early adopters identify the firms that have delivered success, productivity, outcomes, meaningful use achievement and crucial stimulus fund requirements among mobile EHR applications," states Black Book's announcement.  

2013 is shaping up as the "Year of the Big EHR Switch," as the market and opinion research company calls it, with nearly one in five physician users indicating the high likelihood of shifting systems after disappointing first vendor results. Consequently, Black Book says several new EHR integrated mobile apps having been added to the list of physician must-haves and that 122 vendors will introduce fully functional mobile access and/or iPad native versions of their EHR products by the end of 2013. In addition, another 135 EHR product vendors claim to have mobile apps on their near strategic horizons.

ONC likes to boast that as of January 2013 more than 210,000 healthcare providers have either adopted, implemented, or upgraded their EHRs or met Meaningful Use criteria. In addition, they cite the fact that EHR adoption has tripled since 2010, increasing to 44 percent in 2012 and computerized physician order entry has more than doubled (increased 168 percent) since 2008. But, these statistics belie the fact that when it comes to overall satisfaction and usability ratings, EHRs are losing ground. The good news is that mobile technology could help to turn around what so far have proven to be disappointing initial results. - Greg (@Slabodkin