EMR Benefits: Physicians

Benefits

On the medical record.com website it states the benefits from the physician prospective

• Finish patient charting quicker
• Evidence of EHR benefit to ED physician

voice recognition of an EHR for data entry significantly decreases work flow interruptions for an Emergency department physician.

• which then allows scheduling of more patients
• efficiency of charting.
• real time charting instead of hours later.
• in return accuracy of the patient health record.

Physician Recruitment

68% of physicians surveyed by the National Center for Health Statistics report that the implementation and use of electronic health records is seen as an asset when recruiting physicians to their practice.

Physician Satisfaction

An association has been shown to exist between EMR use and physician satisfaction with their current practice[76], as well as with their career satisfaction [77].

55% of physicians surveyed by the Medical Economics reported to be fairly or very satisfied with the use of their electronic health record.

Physician Improvement through Satisfaction

A recent paper released from Louis Raymond and his team in Canada showed that family physicians in their area of study were doing well with the use of EHRs. Five hypothesis were tested and found to be either partially or fully supported by the evidence gathered from the study. One such hypothesis was the “[e]xtended use of an EMR system is positively and significantly associated with performance benefits.” One benefit that the team mentions is how Raymond and his team have concluded that there is a need to use EMRs more in the workplace to be able to have the maximum amount of benefits for the users.

Standardization of Practice

Although publication of evidence-based medicine abounds, it has been noted that physicians do not practice according to proven guidelines. The reasons are numerous. One of them is that busy physicians do not have the time to read publications that have increased exponentially. Another is the innate human limitation in the capacity to integrate information during decision-making. This has led to a decline in patient care standards. CDDS can increase compliance with evidence-based practice by presenting the needed information to the clinician at the point of care. And while there is resistance to its use from physicians who view CDSS as an out of the box practice that is not tailored to their clinical workflow, it has been noted that incorporating factors such as patient-specific information, consideration of comorbid conditions, and organized and explicit presentation, might result in increased CDSS utilization.

Meaningful Use

The incentive program set forth with the HITECH Act encouraged the physician adoption of EMRs. Those providers who were able to demonstrate meaningful use of the EMR system would receive incentive payments from the federal government. A study published in 2014 found that those providers with certified EMRs met and exceeded the CMS meaningful use guidelines published. Providers met 15 core measures related to EMR functions and submited an attestation of meaningful use to CMS. Most of the providers were able to meet the core measures by 90-100%, even in measures requiring only 30% compliance. This study showed that providers could achieve a higher degree of meaningful use with key EMR features and received incentive payments of $18,000 for achieving meaningful use.

EMR and Providers’ Productivity

Health care providers are adopting electronic medical records, but some doctors report a disturbing side effect. Instead of becoming more efficient, some practices, especially smaller ones are becoming less. As with all new systems, there will be a temporary reduction in productivity as the healthcare staff become familiar with the new system. A study by Menachemi and Brooks (2006) estimated a 20% loss of productivity for the first month, 10% loss in the second month, and 5% loss in the third month and finally productivity returning to baseline in the subsequent months. . Several studies indicated that when physicians spent extra time entering data themselves, it cut down time spent with patients and stretched out their workday. [70]

In a study by Bhargava et al. which examines productivity impacts of electronic medical records (EMR) implementation in a large academic hospital in California. Bhargava et al. also investigate the dynamics through which EMRs may impact productivity. The study employ random effects model on panel data comprising 3,189 physician-month observations for productivity data collected on 87 physicians specializing in internal medicine, pediatrics and family practice. The total duration of data collection was 39 months. Bhargava et al. find that the productivity of physicians dropped immediately after EMR implementation, but began to recover in a few months and finally leveled-off. Additionally, Bhargava et al. find that productivity impacts of EMR are contingent upon physician specialty. Bhargava et al postulate that the fit provided by an EMR to the task requirements of physicians of various specialties is key to entangling the productivity dynamics. [71]

Improve efficiency and patient throughput

The Institute of Medicine estimates that $17-29 billion is spent annually on unnecessary or inaccurate patient care due to misdiagnosis. If clinicians can rapidly determine the correct dose, calculation or diagnosis, they can order relevant tests and make appropriate referrals, saving time and eliminating unnecessary costs for the patients and the ED. Of course, CDS is most effective when it is built into the clinician’s workflow, which minimizes interruptions and dangerous distractions. It is also important for CDS to be incorporated into providers’ workflow in such a way that minimizes alert fatigue..

A well designed EMR can enhance the ease and time efficiency of cognitive performance. In a 2011 study, providers cited several factors inherent to an EMR which improved their personal performance and help them provide more efficient and, ultimately, safer care:

• Easy access to patient medical history
• Able to access information not previously available
• Ability to access patient information from multiple settings
• Immediate access to patient record
• Accessed information is more legible

Relationship with Pharmacies and Prescribing

Financial Incentives: Physicians tend to be resistant to adopting use of EMR, despite other healthcare areas readily using electronic records. Pharmacies took the lead in healthcare informatics in the 1960s with the use of automation. They still lead the way but are providing opportunities for physicians to join the informatic arena. Electronic prescribing is one link between the groups and there are many incentives to increase the usage of e-prescribing programs. In 2007 CMS allowed for increases in reimbursement to physicians and providers who utilized these programs. Since that time more than $4 billion has been awarded to participating clinicians.

Fewer malpractice claims

Researchers in Massachusetts have found that physicians using an EHR had fewer paid malpractice claims. Specifically, they found that 6.1% of physicians with an EHR had a history of paid malpractice claims compared with 10.8% of physicians without EHRs. This reduction is potentially the result of increased communication among caregivers, increased legibility and completeness of patient records, and increased adherence to clinical guidelines.

Solo and Small Practices

Studies have been conducted to see how small and solo practices transition into the use of electronic health record. It has been noted that it has been useful in some cases, making for a very profitable investment. However in some cases, it took a considerable amount of time to pay for the transition and seeing any return on investment. Due to these results, its recommended that companies promoting the use of electronic health records should offer incentives to small and solo practices as to ease the potentially difficult transition process and financial burden.