Study: Small practices face major barriers to EHR adoption

Doctor with computer and gadgets
Doctors in smaller practices face major financial hurdles to fully implementing an electronic health record.

Smaller practices face large cost and time hurdles to implementing electronic health records, including possible closure, according to a new study.

Researchers surveyed an expert panel of 15 small-practice physicians (those that work individually or in groups of two to four) in various specialties and locations and found they were concerned about the costs associated with upgrading to an effective EHR. Doctors are especially worried about the financial impact of technological upgrades in the face of the healthcare industry’s physician shortage, according to the results published in the American Health Information Management Association’s Perspectives in Health Information Management publication.

“The unknown impact of the EHR on their practice has small-practice physicians unsure of their future and the future role of small physician practices,” according to the study. “With physician shortages continuing to mount, the financial future of the healthcare practice has become a paramount concern of practitioners.”

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Another cost concern for small-practice doctors was the amount of time spent with EHRs, according to the study. Reduced patient volume because of the new tech could be financially devastating for these smaller groups. One panelist noted that one colleague’s patient volume dropped from about 30 a day to 12 after implementing an EHR, which led that doctor to join a larger practice instead. About half of the panelists (47%) expressed concerns about losing money from seeing fewer patients.

The doctors were also concerned that increased time spent with EHRs could reduce the quality of patient care, according to the study. About 53% said reduced face-to-face time with patients was a major worry. A recent study from the American Medical Association found that doctors spend two hours with EHRs for every hour they spend with patients, and the time required to effectively input data into the systems is a major contributor to physicians’ mountains of clerical work and burnout.

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One solution posited by the study was for smaller practices to hire medical scribes in a permanent role, and the researchers called for further study on their effectiveness in improving these issues.