Yes/ No? Has Using an EMR Increased Efficiency?

In a recent survey, seventy-five percent of physicians working in small and medium practices said that using an electronic medical record has increased their efficiency. Drchrono, a company that provides an EMR for the iPad, surveyed 1,300 physicians about the impact that going digital has had on the way that they practice. The average reported time savings due to using an EMR was about 62 minutes per day.

The results are notable because they come from a fairly large survey, and because they contrast with several recent negative studies, as well as negative feedback from the physician community, around the adoption of EMRs. And now that it’s been more than three years since the United States government made a big push to get more doctors plugged into technology with the signing of the HITECH Act in 2009, there’s data available to start critically looking at the effectiveness of the EMR.

Drchrono focused in on a subset of physicians ― its user base, which includes general practitioners, pediatricians, internists, orthopedists, chiropractors, psychologists and others who practice in groups of 25 or fewer. The company emailed users and collected responses between July and August 2012.

Because the results reflect the feedback of drchrono users almost exclusively, they can be interpreted as positive customer satisfaction results. But they can also be taken as positive feedback for EMRs in general that are designed to make the government incentive program Meaningful Use less of a headache.

“Because we are a younger company, Meaningful Use was always in the back of our mind when we started the company, and it really progressed to the point where we think OK, how do physicians interact with their patients, and how do we get Meaningful Use reimbursement? It should all come together,” drchrono CEO Michael Nusimow said.

Judging from anecdotes from around the blogosphere, Meaningful Use is the bane of many doctors’ existences. For example take Dr. Rob Lamberts, a primary care physician from Georgia, who has used digital records in his office for 16 years. Before adopting Meaningful Use standards, Lamberts said he used to be able to customize his workflow to maximize his own productivity.

“Last year, our first year in the ‘meaningful use’ era, our focus changed in a very bad way. We started talking more about our EHR complying to criteria than maximizing quality and efficiency. Our vendor jumped on this bandwagon, ignoring the fact that they were stuck in a pre-internet, office-network design, and instead put all of their resources into letting their users meet ‘meaningful use,’” Lamberts wrote.

Then there are studies and surveys that suggest more drawbacks to going digital in general. A recent study published in Health Affairs found that electronic access to imaging led to a 40% to 70% increase in imaging tests, which has negative implications for health care costs.

Also, there’s patient resistance. A Xerox/ Harris Interactive poll found that only 26% of patients want electronic medical records.

On the other hand, drchrono’s survey results suggest that patients who already have digital records are happy about it. Eighty-two percent of physicians said that patient feedback on their practice’s EMR use has been positive. Nusimow said that getting patients on board with electronic records and digital communication has helped doctors to become more efficient. He explained that the survey showed pediatricians saw one of the biggest time savings when they used an EMR.

“What we draw from that is pediatricians are treating children, and their parents ― the primary care takers ― are right around the age where they’re very tech savvy, and very concerned with their children. So they engage a lot more on the Web with their doctors. The more the patients are engaged, the more time savings the doctor had,” Nusimow said.

Dr. Surinder Saini, a gastroenterologist practicing in Newport Beach, California who filled out the survey, said that his patients like that he uses electronic records.

“They totally buy into this concept because they don’t have to fill the paper out time and again. They can just edit it when they come if there’s any issue,” Saini said. “They have their prescription waiting for them when they go to the pharmacy, rather than taking a paper prescription and waiting for 30 minutes for the pharmacist to fill it.”

In so many ways the verdict is still out on EMRs. But over the coming years physicians are going to continue to go digital (the deadline to apply for Meaningful Use incentives is today), and over the coming years, we’ll have more data to slice and dice on user satisfaction, gains in efficiency, and the overall effect of EMRs on the way that medicine is practiced.

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