Report: EHRs Fall Short, but So Does Physicians' Use

A recent report from Price Waterhouse Cooper’s Health Research Institute (HRI) says that, while electronic health records (EHRs) have become ubiquitous in recent years, the systems still have significant room for improvement.

In interviews with 15 executives from healthcare systems across the US, as well as clinician, consumer, and provider surveys conducted in 2017, HRI found that 96% of nonfederal hospitals and 87% of office-based physicians now use EHRs, and that these entities largely transitioned to EHRs as a way to gain federal incentives for meaningful use. Only an approximate 25% of providers “agree wholeheartedly” that using EHRs has helped their organizations to meet the demands of population health, consumer needs, or competition.

Practices that implemented EHRs as part of an overall business strategy rather than as a way to gain federal monies appear to have fared better with EHRs—92% of strategic implementers agree that their EHR system has met expectations for communicating with patients, while only 76% of meaningful use implementers agreed with the same statement. Yet physicians in practices of all types find that data entry exhaustion, operational inefficiencies, and EHRs’ focus on the revenue cycle are negatively impacting their delivery of care.

“The care processes are too heavily impacted by what we have to do to get the billing right,” Alex Rodriguez, chief information of officer St. Elizabeth Medical Center told HRI.

Limitations to EHRs mean that a number of providers are currently seeking support from non-EHR technology to bridge the gaps in their systems:

• 31% of practices are investing in core support technology to address such areas as clinical documentation, revenue cycle management, clinician workflow management, and back-office workflow management.
• 36% are invested in population health solutions to assist with clinical decision-making and data warehousing.
• 41% are adding technologies to help with care management and patient engagement activities, including provider-to-provider and provider-to-patient communication.
• 42% are investing in technology and subject-matter experts for research and clinical trial recruitment needed to do robust data analysis.

While EHRs fall short in the above areas, the report also suggests that physicians, especially those who adopted EHRs for meaningful use incentives, have room for improvement in utilizing their systems; for example, only 41% of meaningful use implementers pointed to revamping the patient experience as a priority, only 29% use EHRs for care coordination, and even fewer (27%) use EHRs for provider-to-provider communication.

However, consumers appear to see more value in EHRs than their physicians; 87% of consumers (compared with 59% of clinicians) surveyed by HRI agreed that EHRs made it easier for them to communicate with their doctors, and 78% agreed that EHRs have improved the patient experience (compared with 58% of clinicians).

Finally, the report offers 4 recommendations for practices that are hoping to get the best from their EHRs:

• View the EHR as a strategic asset in patient care, not simply the cost of doing business. “We need to redefine success factors—readmissions, sepsis, how are we measuring it. It’s not necessarily financial. The guiding principle is safety and quality of care patients want and deserve,” said health information technology expert Jessica Cornelius.
• Improve data governance. Organizations should have a person in charge of the organizations’ data, and should track how that data is used.
• Buy, rather than build, data models. Practices that create their own systems may find that their products cannot compete with those of EHR vendors. Trusted developers are likely to be able to bring deeper insights into the market.
• Use proprietary data as a revenue source. Providers may want to consider packaging and selling data that they extract from EHRs, and should consider investing in predictive models that can suggest products and services to help consumers manage their health.