Docs Value EHRs, But Older Physicians Lag In Adoption

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Two-thirds of doctors say they use some form of electronic records to manage clinical information, and a similar number believe IT can improve care in the long term, according to a study from the Deloitte Center for Health Solutions.

Physician Perspectives About Health Information Technology, which relied on an online survey of 501 physicians, also reveals an age bias toward electronic health records (EHRs), noting that older physicians are less likely to push for adoption of the technology (42% of those age 60 or older compared to 76% age 25-59).

"Adoption of IT by older physicians is likely a reflection of use of IT by others of their generation, though that is still significant and fast-growing," Dr. Harry Greenspun, senior advisor for the Deloitte Center for Health Solutions, said during an interview with InformationWeek Healthcare. "Bear in mind that older physicians have spent nearly their entire professional lives using paper charts, whereas many younger physicians have only used EHRs. The finding of lower use among female physicians warrants further investigation."

Despite these differences, however, the consensus is that EHRs are a valuable tool in improving quality (84%) and important to managing patient care (79%). The poll also found that more than 60% of physicians don't believe EHRs have improved diagnosis accuracy or treatment planning. With regard to liability, only 22% of physicians in groups of 10 or more feel that EHRs are too risky, compared with 48% of solo practitioners who voice this concern.

The report also showed that, measured against the IT goals and deadlines prescribed by the Patient Protection and Affordable Care Act, only 25% of physicians said they are "on target" to meet the Meaningful Use incentives.

[ Some healthcare organizations are taking a proactive approach to Meaningful Use changes. Read more at Look Beyond Meaningful Use Stage 2. ]

The survey indicates that although large-group practices are more aggressively adopting IT, physicians in larger practices are less familiar with regulatory issues, meaningful use criteria, and ICD-10 requirements. For example, more than one-third (39%) of physicians in practices with 10 or more full-time employees are not familiar with the Health and Human Services standards for ICD-10, compared to only 25% in solo practices.

"The biggest surprise was the extent to which doctors in larger groups seem to have lost touch with many details that will impact how medicine is practiced for years to come. In larger groups, layers of management insulate physicians from the details of healthcare reform and technology," Greenspun said. "Physician leadership and participation is essential to the success of many of these initiatives, so unless the doctors are well-informed, progress may be difficult."

The poll also suggests that doctors are more confident about being able to meet the ICD-10 implementation, with just 21% reporting they cannot meet the October 2013 deadline. The survey was taken before the Department of Health and Human Services announced that it will push back the deadline for ICD-10 implementation.

Other key findings of the survey were:

-- Financial investment and impact on productivity are the primary barriers to EHR adoption, with 66% citing upfront financing as their primary concern and 54% saying this about operational disruptions.

-- Differences in the use of electronic health records among single versus group practices could widen health gaps among communities, as some rural and urban areas served by single practitioners are less likely to employ health IT. Nearly one half (46%) of single practices do not use EHRs, compared to 22% of group practices with 10 to 49 full-time employees. Furthermore, 45% of solo practices have no plans to use EHRs, compared to only 15% of practices with 10 to 49 full-time employees.

For those physicians that have resisted adopting health IT, Greenspun believes physicians will more readily adopt EHRs over the next two years as pressures mount to demonstrate value around evidence-based care, improved outcomes, and reduced complications.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)