Report: EMR Industry Must Reckon with Physician User Frustration

ROCKVILLE, MD – A new study by health care market researcher Kalorama Information has found that physician frustration over the use of EMR systems will be a trend for vendors to deal with. Previously, incentives paid to providers to buy and use electronic medical records were enough for a market boost, but now user frustration is driving vendor switches and contributing to implementation costs. Kalorama has covered EMR for a decade and has issued a new report: EMR Market 2017: Electronic Medical Records in an Era of Disruption.

Kalorama based its findings on attendance at the 2017 HIMSS conference, and from vendor and end-user consults.

“During the HIMSS 2017 conference, discussions revolved around physician dissatisfaction with EMRs,” said Mary Ann Crandall, author of the report. “Physicians still feel that vendors are missing the mark when addressing the needs of physicians.”

Physicians have repeatedly complained that EHRs are difficult to use. Many EHR interfaces are awkward and non-intuitive creating more problems than solutions. Physicians are not convinced that EMRs will cut costs or help to provide better and safer care. One of the reasons for this may be that vendors do not seem to be in touch with what physicians need in their individual practices. Furthermore, EHRs often get in the way and slow users down because of the way they are configured or are not convenient to use. Most EHRs are not designed to help physicians juggle the simultaneous tasks they all face, like answering a question about one patient while in the middle of writing a prescription for another. In addition, because most of the programs that are on the market were developed many years ago before today’s sophisticated interface tools were developed, it compounds the problems.

“Furthermore, physicians get tired of having to sign into multiple hospital systems to locate data on their patients. Smartphones, iPads and the Internet are so intuitive and well integrated that they make EHRs look even worse,” said Crandall in the report.

A survey of nearly 3,000 physicians reported that most physicians do not like the Affordable Care Act and many of them do not like EMRs. Only 30 percent of the physicians surveyed think that EMRs will have a positive effect on the quality of care. One big reason for the sour feeling it that  Medicaid and Medicare reimbursement continues to fall, and Medicaid will cover many of the 32 million uninsured individuals targeted to be insured under the law. The survey also did not show a lot of support for accountable care organizations, which is an emerging payment model authorized in the reform bill.

Crandall said physicians feel that there needs to be a concentrated effort to focus on evidence, accuracy, how it is integrated with the physician’s EMR and how it is integrated within the practice. According to Michael Hodgkins, AMA CMIO, physicians are spending twice the amount of time on deskwork and EHR maintenance, including 38 hours a month spent on EHRs after work hours. This is creating dissatisfaction and contributing to burnout for physicians. Michael Hodgkins further stated that physicians just want to provide high-quality care, but EHR work seems to get in the way. At the same time, practice sustainability and changing reimbursement models that favor scale and shift risk to the providers is leading many practices to merge or sell out altogether.  Simply, physicians are overwhelmed with platforms, apps, regulations and computer work.

Several vendors are listening to the physician complaints and are attempting to make changes. Kalorama reported in April that Allscripts is developing separate workflows for mobile devices and desktop computers, and will focus on touch speech recognition and other non-keyboard interfacing techniques that will help to improve physician perception.

Kalorama notes that while there are a few leaders in the EMR market, there isn’t much brand and mind share and few favorites among physician users. Greater detail on these trends are included in Kalorama Information’s report, EMR 2017: Electronic Medical Records in an Era of Disruption.