- EHR systems continue to fall short of provider expectations and detract from the joys of practicing medicine, according to a recent national survey by The Doctors Company.
More than 3,400 physicians from 49 states and the District of Columbia offered their perspective on EHR technology, federal regulations, value-based care, patient-centered medical homes (PCMHs), and other aspects of the healthcare system.
Survey respondents included surgical specialists, primary care providers, and nonsurgical specialists. The majority of respondents were 51 and older.
Overall, the majority of surveyed physicians reported that EHR systems have had a negative impact on the patient-provider relationship, clinical workflows, and clinical productivity.
Fifty-four percent of surveyed physicians stated their belief that EHR technology negatively affects the patient-provider relationship, while 61 percent of respondents reported feeling that EHR systems disrupt clinical workflows, reduce clinical efficiency, and lessen clinical productivity.
Few respondents had a positive view of EHR vendors.
“Only 14 percent of doctors reported a positive experience with EHR vendors, with the rest split on whether the service has been neutral or negative,” stated authors in the report.
While most physicians believe EHR technology has had a negative effect on patient care delivery, respondents had mixed feelings about the effects of value-based care.
“Nearly half of the doctors surveyed believe value-based care and reimbursement will have a negative impact on overall patient care,” authors wrote.
“Many doctors worry that pay-for-performance reimbursement doesn’t take into account the nuances of the doctor-patient relationship, and puts a focus on population-level data instead of individual outcomes,” they continued.
The regulatory demands that accompany the shift to value-based care weigh heavily on providers, with most respondents naming EHR systems and federal regulations as the top causes of physician burnout.
Additionally, a substantial portion of respondents stated value-based care will force independent practices out of business.
Sixty-one percent of physicians reported feeling that value-based care and reimbursement will have a negative effect on their practice. Furthermore, 63 percent of respondents stated value-based care and reimbursement will negatively effect their earnings.
“Documentation and data collection required under value-based care is resulting in additional costs and strain on resources,” wrote authors.
“Some doctors feel that value-based care is pressuring them to succumb to industry consolidation and lose their independence,” they added.
Nearly a fourth of doctors expect to work as part of larger business models in the future out of necessity. Twelve percent of respondents anticipate joining a large group practice, seven percent may be employed by a hospital, and three percent anticipate joining an integrated healthcare system.
“Private practices are increasingly being acquired by health systems that want to better control the continuum of care, and some medical groups are merging to create larger practices to drive efficiency, cost savings, and better technology,” wrote authors.
Though value-based care may pose a challenge to the business model of the independent practice, nearly 75 percent of solo practitioners plan to stay independent.
Respondents also have a generally negative perception of PCMHs, with 56 percent of respondents stating they do not plan to participate in the care delivery model.
“Practicing medicine has taken a back seat to jumping through hoops for insurance companies, Meaningful Use, PCMH requirements, formulary changes, prior authorizations, and pay for performance,” said one survey respondent.
Ultimately, providers are generally wary of recent changes to reimbursement, federal regulation, and care delivery.
Physicians’ general dissatisfaction with EHR technology and value-based care echoes the findings of a recent JAMIA study.
According to Meyerhoefer, et al. at Lehigh University, patient and provider satisfaction with EHR systems remains lacking despite improvements in health data availability, access, and exchange.