Many physicians who use an electronic health record (EHR) are having difficulty realizing value in their investment. A recent KLAS survey found that more than one out of every four physician practices are so dissatisfied with their EHR that they are considering replacing it. Although many physician practices have earned a financial award by using an EHR to achieve “meaningful use”, data is lacking on whether or not such efforts actually improve patient outcomes.
I believe, anecdotally, that I practice higher quality medicine when using an EHR. But I am a pediatric emergency medicine physician using a hospital EHR to document patient encounters in a children's hospital's emergency department, not a physician in private practice. On the other hand, my past experience as a a Chief Medical Information Officer (CMIO) and Chief Information Officer (CIO) for my pediatric healthcare system provided opportunities to visit many private physician offices using a variety of ambulatory EHRs and to visit with many EHR vendors. I met many physicians who were happy with their EHRs and see the value. Others I met were unhappy and see no value in their EHR. Perhaps my most eye-opening experience came when I visited with a group of unhappy physicians who were using the same EHR as some happy physicians I had met one week earlier. So what gives?
The answer is simple, but the explanation is complex.
The simple answer is that the value gained from an EHR is dependent on how effectively it is implemented and used. When well-implemented and well-used, an EHR provides clinical and financial value. When poorly-implemented and poorly-used, EHRs detract from patient care and are a financial drain.
The complex explanation might best be explained using examples. So, based on my past visits with physicians who use various EHRs and on other personal research, I have created an outline of what I think are the key factors that allow physicians to gain value from their EHR. I am in the process of writing a series of blogs with case studies to help explain each of these factors. Stay tuned!