Embracing Electronic Health Records
Lisa Moss Calderwood, MASenior Medical Writer
My primary doctor of the past 20 years has the tiniest handwriting. He’s fastidious about documenting what we discuss during exams and a visit with him is usually a solid half hour or more. I’ve learned to be patient and not speak while he’s writing. We have our routine: we chat, he examines me, we chat some more, and he takes his notes. His office hasn’t changed over the years either—the reception room’s wood paneling and travel photography have been the décor for as long as I’ve been a patient there, not to mention some of the posters on the wall in the exam rooms. I guess there’s some comfort in that constancy. But there are some not-so-small changes going on.
A couple of years ago my doctor and his wife, a family nurse practitioner who is part of the practice, began transferring thousands of patient files into electronic health records (EHR). At first it made me uncomfortable as everything I said seemed to be going into a huge database. I wondered how secure it was. Then I learned that he was following federally mandated guidelines for healthcare practitioners (HCPs) to have a certified EHR. Now when I see him, he turns to his laptop and enters everything electronically. It still seems to take the same amount of time, and I’m not sure if it’s because he types as carefully as he writes (and we still chit chat), but I imagine that my data is now in the EHR cloud. I still have to take out my reading glasses to read his writing on my prescriptions, so he’s still using that MD handwriting.
I wondered what it was like for traditional docs like mine to make the leap to EHR and how others are following suit—or not. Some practices are more resistant, perhaps Luddites not interested in taking on the technology, whether it’s for patient records or even setting up more efficient office systems. But the cost to adopt EHR is also a significant factor, especially for a single primary doctor—about $30,000 to install a system, and $2,000 in monthly fees, according to Olga Khazan’s illuminating piece inThe Atlantic about why more docs aren’t tech-savvy.1 She notes that, to her frustration, some of those same EHR-avoiding doctors also avoid e-mail access and online scheduling.
Khazan acknowledges that some doctors are resistant because they fear abuse of patient data, the amount of work it takes to transfer thousands of files, or additional staff needed to properly use EHR. But, she reports, some larger practices are thriving and taking full advantage of the potential features the EHR system provides: “You can e-mail with your doctor or nurse, get medical records released by filling out a short online form, and schedule appointments or renew prescriptions with an iPhone app.”
As a medical writer of patient and HCP educational materials for Artcraft Health, I think of the broad teaching possibilities to help empower physicians and their colleagues to efficiently embrace EHR. How about education about EHR to acquaint patients with the process and explain to them why their doctors are collecting and sharing data about their health and medical history? If the ultimate goal of EHR is to foster a more patient-centric healthcare system, then responsive training is vital to its success.
In fact, physicians are not receiving adequate training either, according to Jeff Rowe inHealthcareIT News. “At least three to five days of EHR training was necessary to achieve the highest level of overall satisfaction” with a new EHR system, but “nearly half (49.3 percent) of respondents [in a survey] indicated that they received three or fewer days of training.”2 That may explain why more physicians are not yet onboard with EHR.
About 54% of physicians nationwide have embraced EHR, according to a recent survey.3The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act states that HCPs and hospitals must adopt EHR to “advance the use of health information technology by providing Medicare and Medicaid incentives to physicians and hospitals that adopt and demonstrate ‘meaningful use’ (MU) of [EHR] systems.” HITECH also states that EHR must be adopted by practices and hospitals by 2015 to be compliant and receive “meaningful use” compensation (reimbursement incentives to practices and hospitals by the Centers for Medicare & Medicaid Services).
According to HealthIT.gov, meaningful use of certified EHR technology enables practitioners to improve quality, safety, and efficiency, and reduce health disparities, while maintaining patient privacy. Essentially, the government website says, “with EHRs, information is available whenever and wherever it is needed.”4
The “real-time” advantages of EHR ideally offer integrated access to a patient’s medical history, diagnoses, medications, test results, and more. Physicians can also obtain evidence-based tools to help make care decisions, streamline workflow, increase accuracy, and stay on top of payer requirements. EHR consolidates information across healthcare facilities, including laboratories, medical imaging centers, or schools.
So I’m proud of my primary doctor for getting on the EHR bandwagon despite his office’s old-world feel and his meticulous handwriting. He has embraced the technology and has joined half of the country’s practices in doing so. Maybe he’ll upgrade to the multifunctional EHR service that allows for e-mail access, electronic prescriptions, and other whistles and bells. But for now, I’m happy to enjoy the mix in his office of technological progress and a very caring patient experience.
- Khazan O. The Atlantic Monthly. Why aren't doctors more tech-savvy? January 21, 2014. http://www.theatlantic.com/health/archive/2014/01/why-arent-doctors-more-tech-savvy/28. Accessed January 27, 2014.
- Rowe J. HealthcareIT News. Providers need proper EHR training. October 25, 2011. http://www.healthcareitnews.com/blog/providers-need-proper-ehr-training. Accessed February 6, 2014
- CDC. National Center for Health Statistics (NCHS) Data Brief Number 98, July 2012. Physician Adoption of Electronic Health Record Systems: United States, 201.1 [Updated 2013]. http://www.cdc.gov/nchs/data/databriefs/db98.htm. Accessed January 27, 2014.
- Benefits of electronic health records (EHRs). HealthIT.gov. http://www.healthit.gov/providers-professionals/benefits-electronic-health-records-ehrs. Accessed January 30, 2014.