Despite near universal agreement among healthcare providers that electronic health records are a good idea, as well as the monetary incentive of the Centers for Medicare and Medicaid Services meaningful use program, many providers are having difficulty taking full advantage of EHR software.
Early EHR support
When the Obama administration first announced its plans of offering $30 billion of incentives to doctors who adopted EHR programs and met meaningful use standards, most HCPs were supportive. Indeed, many have taken efforts to modernize and digitize their records and billing systems. According to Politico, only 48 percent of doctors used some kind of EHR in 2009. In 2014, that percentage has risen to more than 60 percent. Many of these HCPs have received a significant incentive payout as well.
Failure to launch despite incentives
A recent report in HealthITNews cited that the CMS has already distributed nearly $24 billion to providers who can attest to meaningful use standards for EHR software. However, 22 percent of doctors have actually opted out of the program, forgoing the opportunity to earn meaningful use incentives and exposing themselves to the possibility of being penalized on their Medicare Part B reimbursements. The primary for HCP dissatisfaction with EHRs? According to Politico, doctors think EHRs are "clunky."
This is a fair point for much EHR software, which was rushed to meet deadlines set by the White House and the CMS. Many of these programs were cobbled together by tacking extra lines of code onto software that was written as far back as the 1970s to help with medical coding and billing. Today, the demands of comprehensive patient care outstrip the capabilities of many of these outdated computerized record keeping systems.
Worse still, some HCPs, especially smaller offices, find the cost of adopting EHR software cripplingly prohibitive. Although they understand that they will eventually receive incentives for adopting EHRs, they do not have enough seed money to front the initial costs of buying new software and training their staff. Moreover, the news is filled with million-dollar muddles of all sorts as hospitals attempt to adopt EHR software that does not deliver what it promises.
Catering to the customer
At this point, the question becomes: how can EHRs regain the trust of health care providers? An article on iHealthBeat titled "Lack of Clinician Input, Training Cited in Troubled EHR Rollout" suggested that two of the biggest contributing factors to the problematic EHR rollout has been clinician input and provider training. When a medical office adopts a new EHR program, its staff has to learn how to use the new software while carrying on business as usual. This can be an impossible logistical problem for large hospitals or any overly busy practice. When HCPs do not have enough time to take care of all of their usual business over the course of the day, it can be a challenge to find opportunities to learn a new system of keeping patient records. As a result, many HCPs simply forgo the use of EHRs, even if their practice has adopted a system. In other cases, they fill out the EHRs, but their engagement is subpar, resulting in what is little more than a cumbersome electronic notepad. This is troubling considering that EHRs could perform so much more effectively.
The whole point of EHRs is to reduce the chances of medical error, increase efficiency and provide caregivers and patients access to complete, accurate and up-to-date medical records. For many practices, EHRs have done the opposite of this since time management prohibits sufficient training of employees. Therefore, it is the task of EHR vendors to develop software that is more intuitive, human friendly and catered to the specific needs of the healthcare providers they serve.
Combined efforts and user feedback
Vendors and developers cannot do this alone. These people are computer engineers, software coders, sales force and PR professionals. Even if they come from a medical background, they are not always up to date with the industries they serve. EHR technology can only be successful if both vendors and providers work together as a team. According to the same iHealthBeat article, successful EHR projects are clinically driven, not IT driven. When providers offer feedback to vendors, then the vendors can develop software that is catered to the precise needs of their clients.
Improved communications between vendors and providers have already begun. According to the article "Coalition Calls for Action Against EHRs That Block Interoperability" in iHealthBeat, several healthcare providers have banded together to try to keep EHR vendors from marketing EHR software that does not allow records to be shared with other hospitals or offices. This is in response to the distribution of software packages that require additional purchases in order to unlock interoperability. While this is a good example of how healthcare providers can provide feedback to help improve the functionality of EHR software, it might not be the best case of teamwork between HCPs and vendors. Nonetheless, it is a step in the right direction by opening communications. With any luck, future efforts to coordinate will be more productive and less antagonistic.