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	James L. Holly, M.D.

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In The News - EHRs a bright spot in uncertain times

Physician survey

Record Review
by Patty Enrado

Posted on Mon, Mar 29, 2010 - 12:58 am

A recent survey conducted by health IT vendor athenahealth and Sermo, an online physician community, painted a pretty grim picture of how physicians are feeling about the future of medicine. The survey involving 1,000 physicians point to discontent from the quality of healthcare delivery to the burden of payer administration and reimbursement.

Against that background, the numbers surrounding EHRs are somewhat better. Eighty-one percent of physicians held a very favorable or somewhat favorable opinion of EHRs.

It didn't say that the survey was Internet based, but I'm guessing that it was. I'm also guessing that the physicians athenahealth and Sermo reached out to are likely regular Internet-using physicians. I'll wager a good number of them have EHRs already. So it should be no surprise that EHRs rated so favorably in this physician index.

Only 51 percent of physicians said that EHRs are designed with them in mind. When I hear of complaints about design flaws, I scratch my head. What EHR vendor doesn't have a C-level medical doctor on the leadership team and clinicians on the development team? Why is there such a disconnect? Could it simply be that physician workflow is so unique from office to office? Is there a lot of differentiation among EHRs that physicians would have a choice as to which best fits their office and physician workflow?

So, 54 percent said that EHRs slow them down during patient exams. Any new change would. It's a given. You have to adjust, with the understanding that in the end you should be more efficient and should have more actionable information to assist in clinical decisions. It's a matter of education, training and re-engineering of the physician office. This re-engineering should be shared by office and vendor, or office and consultant.

Sixty percent said EHRs distracted from face-to-face interaction with patients. Again, this is a matter of adjusting to the third entity in the examining room. One hopes all this training and re-engineering is part of all EHR packages; it makes business sense.

Lastly, only five percent of physicians felt that EHRs are alleviating the effort to stay on top of changing payment requirements and incentives. One day EHRs and practice management systems will be integrated in the physician office. When that happens, clinical processes and data will merge with financial and administrative processes and data, resulting ideally in a well-oiled machine.

Comments

Posted by pharris1 on Thu, May 20, 2010 - 12:23 am.

The term "cloud computing" describes the practice of storing all data, software, and hardware off-site, with the system accessible to hospitals and providers via a web browser-based login. No need to install expensive infrastructure, and secure data storage is part of the package. The EHR system is immediately available to any Internet-connected computer in the world. With cloud computing, everything you do is now web-based instead of desktop-based.

Posted by James L. Holly on Wed, Mar 31, 2010 - 06:04 pm.

I read the report last night and forwarded to all my staff (260 staff and providers). We have used NextGen since 1998. I have reviewed all of the EMRs in the survey.

We SETMA, LLP (www.jameslhollymd.com) has used NextGen since 1999. It was no surprise to me that the less expensive EMRs would win this kind of survey. Many of those however will have difficulty meeting "meaning use" standards.

None of them would meet SETMA's requirement for extensive disease management. All of our electronic patient tools are published on our website along with our public reporting of our providers performance on over 130 quality measures including HEDIS, NCQA, NQF, PCPI, PQRI and AQA.

I am not impressed with this survey. It is more a "beauty contest" rather than a judgment of transforming healthcare. NextGen has been the mainspring of SETMA's growth and expansion. We have won every award including the Davies Award, MS HUG's Clinic of the Year and others. NextGen has given us that capacity.

Go to our website. See what is possible with NextGen and then decide where it belongs in the EMR Galaxy. Along with a very few like EPIC, NextGen leads the parade inspite of this poorly constructed and biased survey tool.

James L. Holly, MD
CEO, SETMA, LLP
www.jameslhollymd.comn
409 654-6819

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