EHRs: Which Ones Doctors Like and How Their Lives Changed

Shelly Reese

Disclosures

August 23, 2012

In This Article

How EHRs Affect a Practice

Overall, physician attitudes toward EHRs remained relatively consistent before and after implementation. About 62% of respondents were somewhat or strongly in favor of an EHR before they began using one; 67% were somewhat or strongly in favor after using one. The percentage of those feeling either somewhat or strongly against an EHR increased from 12% to 14%. The upshot? Soliciting physician buy-in and drumming up staff support and enthusiasm on the front end translates to greater satisfaction post implementation.

Physicians voiced several common frustrations, including EHRs' impact on the doctor-patient relationship and physician productivity.

While more than a third (36%) of respondents said that their EHR has had a positive impact on doctor-patient relations, almost as many (30%) said that it has had a negative impact. Reduced eye contact and less conversation with patients have damaged the relationship. "Staring at a screen leads to a more impersonal encounter," wrote one internist. "Frustrated MDs do not make compassionate providers," wrote a neurologist, and "I feel like I'm entering data rather than interacting with the patient," lamented a family practice physician.

EHRs have a profound effect on medical practices, whether positive or negative. About 1 in 7 physicians (15%) said that their EHR has increased productivity, while more than a quarter (26%) thought productivity had suffered. At the same time, 23% said that the system has increased office efficiency.

Ron Sterling, CPA, MBA, of Sterling Solutions, Ltd. in Silver Spring, Maryland, is a national EHR expert and the author of Keys to EMR Success. He believes that decreased productivity likely reflects physicians' personal experience with their EHR, while increased efficiency reflects the experience of the overall practice.

"The decrease in productivity is really about the doctors," explains Sterling, citing physicians who do not learn a system properly and "fight" to do things the way they want rather than following system prompts. Productivity, he says, "is contingent on how well the doctor worked that EHR into their patient model."

Efficiency, by contrast, reflects the system's impact on the practice as a whole. Electronically entering an order may take a physician more time, but it enables others in the practice to manage the order more efficiently, he says. Enhanced efficiency may help explain why 6% of respondents said that their EHR contributed to enhanced practice revenues.

Many physicians don't know about the back-office details or costs associated with their systems. They don't know whether the EHR is Web-based or installed, and a large percentage don't know about monthly fees or installation costs.

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