At many practices, electronic health records are still regarded with skepticism, and their use is still limited. However, those who have studied the issue have found a number of financial benefits to full implementation of EHRs.
Results of a survey published in the Journal of Patient Safety indicate that when full use of electronic health records is employed, patients are “less likely to experience in-hospital adverse events.”
Full use of EHRs? What exactly does that mean?
Well, it might be easier to explain the misconception of what many in the healthcare community think it means.
“A lot of people think that an electronic health record is simply used for billing, because it makes billing easier, and that’s true, it does,” says Cheryl Plettenberg, Ed.D, RHIA, FAHIMA, chair and professor of health information management at Alabama State University. “But it also makes claims turn around faster; it also identifies errors quicker; it also sets up a quality assurance check for all kinds of electronics records usage. But most physicians do not use it for that.”
Missing the Boat?
A recent poll conducted by Sermo, a social media network exclusively for physicians, found major discrepancies between US physicians and their European counterparts where perspectives on the impact of EHRs is concerned.
For example, the poll found that 59% of European physicians say that patient safety has improved as a result of broader use of EHRs. In contrast, only 27% of US physicians share those feelings. And on the opposite side of the coin, 39% of US physicians believe patient safety has worsened due to broader use of EHRs compared with only 11% of those in Europe.
Plettenberg, who is also an adjunct faculty member at Kaplan University’s School of Health Sciences, believes much of the problem is that physician offices are not trained in the full use of an electronic record and the benefits it can provide.
“I have been involved with so many places putting in an electronic record, and every time it’s, ‘I don’t want to do this. This is going to be hard,’” Plettenberg says. “You visit them a year later and they say, ‘I wouldn’t be without this electronic record. I love it.’ But, getting in the door is the hardest piece. The second hardest piece is having all of their staff trained to use it.”
But training is available. Plettenberg says that implementation of the electronic record is offered at Alabama State University as a community service course. She explains it’s not offered at the tech level, but rather at the employee level.
“We teach them system design,” she explains. “We teach them the workflow. And we teach them the implementation of the electronic record, as well as coding all of the international classification of diseases that they have to use when they bill. That’s part of our outreach from here. Anybody can take it. And that’s why we do it, so that we can get physicians, whether they’re at metropolitan centers or at rural centers, can have the ability to learn how to use that.”
Canned vs. Certified
A Data Brief published by The Office of the National Coordinator for Health Information Technology found that while 74% of physicians had adopted a certified EHR, 51% were using only basic EHR functionalities. And according to Plettenberg, there’s a big difference between a certified EHR and a basic one.
“Anyone can write an EHR program,” Plettenberg explains. “You can buy canned programs, but they don’t necessarily have everything you need.”
A certified EHR, on the other hand, assures the purchaser that the system offers the technological capability, functionality, and security to help them meet the established meaningful use criteria. They’re also more expensive.
“Physicians have to know which is the best buy; which is the program that’s going to best suit them,” Plettenberg says. “Can the doctor curve it to their practice? Many of [the EHR programs] can’t do that, but doctors don’t know to ask those questions.”
Most physicians, Plettenberg adds, don’t want to be bothered with the decision-making surrounding EHRs. Instead they lean on their staff.
Plettenberg suggests that physicians need to be smart enough to hire staff that not only know what an electronic record is, but how to use it. It may cost more money up front in the form of a higher salary, but in the long run reimbursement is going to be more advantageous.
“The first year is the hardest,” she says. “It’s like having a newborn. When they first try to walk, they fall down. And they keep falling down until they finally figure it out. The electronic record is the same way.”
But it does require change, Plettenberg says, and change comes hard for everyone.
“But in the long run, they will find out it improves their practice.”