Monday, October 8, 2012

Despite the Hurdles, Texas Physicians Implement EHRs

More Texas Medical Association (TMA) physicians use electronic tools to help them practice medicine than ever before, according to a preliminary TMA survey. Sixty percent of Texas physicians report now using an electronic health record (EHR), up from 43 percent from 2009.

“TMA is pleased to see the good news that more physicians are using EHRs, because they can potentially help improve patient care,” said Joseph Schneider, MD, chair of TMA’s Ad Hoc Committee on Health Information Technology. “But we are very disappointed that a significant portion [of doctors] are experiencing technology and usability problems that can threaten practice viability, patient safety, and continuity of care. For example, 25 percent of physicians were dissatisfied with the reliability of their EHR. For the EHR industry, this is extremely poor performance.”

More than half of physicians — 55 percent — indicated dissatisfaction with productivity and the time it takes to input data. David Fleeger, MD, an Austin surgeon said, “It can be a real drain on a physician’s time and their staff. … At the end of the day, I feel as if I spent more time putting data into an EHR than with my patients, which concerns me.” Another 50 percent reported they are dissatisfied with the effects EHRs have on their practice costs.

“The steep price tag and fear that the technology will challenge the viability of their medical practice are some of the main reasons physicians are not installing EHRs,” said Dr. Schneider.

EHRs can be cost-prohibitive regardless of federal incentives. The average EHR purchase cost is about $40,000 per physician, not including productivity dips during installation and implementation that hurt practice revenues.

To help offset these costs, Texas doctors have taken advantage of federal stimulus money. Forty-one percent of physicians indicated they qualified for the stimulus incentives and either received the first payment or expect to receive it. Of that pool, 45 percent of physicians applied for funds available through Health Information Technology for Economic and Clinical Health (HITECH) Act. Thirty-three percent applied for incentives from Medicare, which can amount up to $44,000; while 12 percent applied for incentives from Medicaid, which can add up to $63,750.

Regardless of the hurdles, most doctors understand the need to embrace electronic office tools. In TMA’s Healthy Vision 2020, Chris Crow, MD, a member of TMA’s Ad Hoc Committee on Health Information Technology says, “Being in a paper world is the same as driving your car either without a dashboard or maybe even blindfolded. If you do not have feedback about how you are doing in your practice, whether it be financial, quality, cost, efficiency, or patient satisfaction, you can’t play in a game where cost and quality matter, which is what the national discussion is around.”

Since 2005, TMA has measured whether physicians are using medical office technologies such as EHRs, e-prescribing, and health information exchange. In April 2012, TMA emailed a survey to 33,808 physicians and residents. By the end of the month, TMA had received responses from 1,733 physicians for a rate of 5 percent. For a complete report, go to

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