CHICAGO — While most US physician view themselves as more proficient at using electronic health records (EHRs) today than they were 2 years ago, fewer of them believe that their EHRs have improved treatment decisions, reduced medical errors, or improved outcomes, according to a 2014 Accenture survey released Monday at the annual meeting of the Healthcare Information and Management Systems Society here in Chicago.

The findings came from a six-country survey of more than 2600 physicians that included roughly 600 US physicians. Seventy-nine percent of the American doctors said they were better able to use their EHRs than they were in 2012. The number of physicians who routinely used secure email and other digital tools for communicating with patients jumped to 30% in 2014 from 13% 2 years earlier.

The information technology (IT) capabilities that US physicians most often used were patient notes (82%), electronic prescribing (72%), receiving clinical test results in their EHRs (65%), electronic administration tools (63%), and electronic lab orders (62%).

Despite their increased proficiency with EHRs, however, the percentage of physicians who believed that EHRs have improved treatment decisions dropped to 46% from 62% in 2012. Similarly, 64% said EHRs reduced medical errors vs 72% 2 years earlier, and 46% said EHRs improved patient outcomes compared with 58% in the earlier survey.

Seventy percent of the Accenture respondents said that health IT had decreased the amount of time they spent with patients. While 90% of the physicians said that better functionality and data-entry systems could improve the quality of patient care, 58% said that their EHR is hard to use.

Optimism Not as High

Kaveh Safavi, MD, head of Accenture's global health business, told Medscape Medical News that, early in EHR adoption, there was more optimism that EHRs alone could drive quality improvement. But physicians have since recognized that the EHR is only a tool that can facilitate change in their practices. "Increasingly, people realize that the EHR must be optimized to make things happen," he said.

As for the physicians' complaint that they're spending less time with patients, Dr Safavi said this affects their perception of patient encounters but has not changed how they view their medical decision-making ability. In other words, physicians don't feel that they're making poorer quality decisions due to their use of EHRs.

Meanwhile, the survey also showed that US physicians have increased the services they now provide to patients online. The number of physicians who offered telemonitoring devices that enabled patients to monitor their health tripled from 8% in 2012 to 24% in 2014.

While it's not clear what's driving this, many physicians work for healthcare systems that are trying to reduce readmissions to avoid Medicare penalties. Home monitoring of high-risk patients, especially those with congestive heart failure, has become an increasingly popular way to cut readmissions.

The survey showed that 82% of physicians believed that allowing patients to update their own records improved their engagement in their own health. Large majorities also said that letting patients do this improves patient satisfaction (81%), boosts understanding of health conditions (72%), increases patient and physician communication (71%), and increases the accuracy of their medical records (60%).

Whatever gripes physicians have about EHRs, Dr Safavi noted, the top three EHR functions used by physicians — patient notes, e-prescribing, and test results that populate their EHRs — are now widely accepted because they make life easier for physicians. "The benefit becomes embedded, and it becomes an expectation," he said.


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