In 2011, the federal government began handing out hefty Medicare and Medicaid bonuses to physicians who demonstrated “meaningful use” of electronic health record (EHR) systems.
Since then, many physicians have lambasted the meaningful use program as a Big Brother imposition of cumbersome technology that elevates data collection over patient care. However, a new study published online December 21, 2013, in Health Services Research reports that nearly 8 in 10 physicians who use EHRs see the software as enhancing patient care — the kind of meaningful use Congress had in mind when it created the incentive program in 2009.
Furthermore, physicians were more likely to report clinical benefits for EHRs if their systems met meaningful use requirements for electronic prescribing, clinical decision support, and other capabilities or if they had charted patient visits with an EHR system for at least 2 years.
To be sure, the authors of the study have a government point of view. Lead author Jennifer King, PhD, works in the Office of the National Coordinator for Health Information Technology (ONC), the agency in the Department of Health and Human Services charged with promoting EHRs. Two other coauthors also are ONC employees, and a fourth works for the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC). Their article comes with the caveat that the views expressed belong to the authors, not their agencies.
Medication Errors Avoided, Critical Laboratory Values Highlighted
The authors base their findings on 2 CDC surveys of office-based physicians in 2011: one that determined whether the physicians used an EHR and another that asked about their experience with the technology. The final sample size amounted to 1727 EHR users. Of this group, 76% said their EHR system complied with meaningful use requirements, and 82% said they had used an EHR system for at least 2 years.
The current study drilled down to specific clinical benefits of EHRs. A clear majority of physicians reported that their system helped them access a patient’s chart remotely (81%) and alerted them to a potential medication error (65%) or a critical lab value (62%). Forty-seven percent credited their EHR with reminding them to provide preventive care such as a vaccine or a cancer screening.
The highest marks for clinical benefits came from veteran EHR users whose systems satisfied federal meaningful use standards. This group accounted for 62% of all physicians in the study.
Table. Clinical Benefits Reported by EHR Users
| Clinical Benefit | All Physicians Using EHRs | Physicians With MU-Certified* EHR Systems and at Least 2 Years’ EHR Experience |
| Overall, enhanced patient care | 78% | 85% |
| Helped you access a patient chart remotely | 81% | 87% |
| Alerted you to a potential medication error | 65% | 70% |
| Alerted you to critical lab values | 62% | 70% |
| Reminded you to provide preventive care | 47% | 55% |
| Reminded you to provide guideline-compliant care for chronically ill | 45% | 54% |
*MU, meaningful use.
Source: Clinical Benefits of Electronic Health Record Use: National Findings. Health Services Research.
The study comes with several limitations, the authors note. “The findings reflect physician perceptions of EHR benefits; clinical quality and outcomes were not independently measured.” Likewise, the study relied on physicians reporting whether their systems met meaningful use criteria without direct validation.
The authors write that they could not conclude that they had found any causal relationships in their study. However, “[t]o the extent that physician perceptions accurately reflect improvements in care delivery, the adoption of EHRs meeting Meaningful Use criteria and growing experience with EHR systems could improve quality of care.”
The authors have disclosed no relevant financial relationships.
Health Services Res. Published online December 21, 2013. Abstract
