New survey reports physicians’ EHR usage

New studies show that electronic health records are becoming the norm across all levels of the health care industry. While the successes are shown in numbers, some doctors are skeptical due to patient and security concerns.

A survey conducted by Medscape utilized a sample size of 18,575 physicians across 25 specialties to determine who is using EHRs, what EHRs are used for and how EHRs have changed their practice.

EHRs' effects on care
Medscape's study shows that 83 percent of doctors using EHR programs. The number of doctors who do not plan on using or buying an EHR system has grown slightly to 7 percent. Forty percent of doctors who do not use an EHR system claim that these systems interfere with doctor-patient relationships, while 10 percent of doctors who do use EHRs claim they have more face-to-face time with patients and 9 percent of physicians can see more patients than usual.

The second most selected reason for not using EHRs is that they are too expensive, which 37 percent of doctors chose. The cost affiliated with EHRs reaches beyond purchasing the software into the expenses involved with switching paper records to digital forms and the time associated with that task. The study shows that only 8 percent of physicians purchased and installed EHRs for less than $10,000, while more than half of the respondents don't know how much it cost them. The same goes for Web-based EHR systems, however, the highest percentage of doctors – 15 percent – using Web-based services pay less than $300 a month. This suggests that EHRs would be in more facilities if they knew alternatives existed.

Why are not all doctors using EHRs?
When the Medscape study analyzed where EHRs were being used, it found that 56 percent are used by physicians in a hospital, while 39 percent use private EHR systems at an independent practice. Only 6 percent of doctors use hospital EHRs for their independent practice. These numbers reflect that EHRs are becoming increasingly popular, yet there could be more coordination between independent practices and hospitals. A recent report from the U.S. Centers for Disease Control and Prevention published in LabHIT suggests that data between EHRs is coded differently. In some severe cases it causes the mistreatment of patients. A different study from the ECRI Institute published in Health Systems Volume 41 Issue 11 suggests that data does not transfer flawlessly between EHR systems. This results in some patients' data being switched and some data not showing at all. An EHR standard would fix these issues.

Security concerns
When Medscape's study separated the results based on the type of EHR, it deduced that installed and Web-based EHRs have a close to even market share – 36 percent use installed EHRs and 29 percent use Web-based EHRs. A consensus of 63 percent agree that either system improves documentation, but physicians still express privacy concerns. As the CDC and ECRI Institute studies also suggested, the Medscape study shows that 48 percent of doctors have lost patient information through a technological malfunction, and 47 percent feel as though they do not have proper control of access to patient information. Seventeen percent of physicians said they have no security concerns at all. "The real risk for small practices is that they do not have appropriate policies and procedures and fail to train their staffs in HIPAA privacy and security requirements," Ronald Sterling, an EHR expert, told Medscape.

This suggests that small practices have more to learn about EHRs and there is not as much to fear as physicians may think. Technical malfunctions can be due to lack of training and doctors who do not have control of access to patient information, which suggests that the data is more secure than believed.