June 21, 2008
NEJM Survey Of Barriers To Using An EMR
A special article in the New England Journal of Medicine this week described the results of a national survey of physicians and their attitudes about electronic health records in ambulatory care.
Physicians have been slow to adopt EHRs, so this study assessed physicians' adoption of outpatient electronic health records, their satisfaction with such systems, the perceived effect of the systems on the quality of care, and the perceived barriers to adoption. The researchers surveyed 2758 physicians, which represented a response rate of 62%.
Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. Primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.
The study concluded that 'physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems. However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. physicians.'
Major barriers included in the study were:
(in order of importance)
Amount of capital needed
Finding an electronic records system to meet needs
Uncertainty about return on investment
Concern that system will become obsolete
Concern about loss of productivity
Capacity to select, contract, install and implement
Resistance from physicians
Concern about legal record tampering
Concern about inappropriate disclosure of patient information
Concern about physicians legal liability
Concern about the legality of accepting electronic records from a hospital
Abstract of Article
Electronic Health Records in Ambulatory Care — A National Survey of Physicians
Published at www.nejm.org June 18, 2008