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Small Practices Express Concern over Effects of EHR Adoption

A new study demonstrates a need for vendors to better educate physicians on EHR implementation as small practices fear closure at the hands of federally-enforced EHR adoption regulations

EHR Implementation

Source: Thinkstock

By Kate Monica

- A recent study to examine the effects of EHR adoption on revenue and patient encounters for small practices finds EHR adoption will likely reduce the number of patient encounters for physicians and, by extension, reduce overall practice revenue.

Using a panel of 15 experts, researchers conducted a three-round survey process to reach a consensus among panelists regarding the effects of EHR adoption.

Panelists expressed particular concern over the potential for a loss of face-to-face interaction between patients and providers.

Furthermore, experts agreed that EHR implementation would shift the focus away from patients and increase the possibility that providers could overlook medical conditions. Averting focus from patients to EHR documentation could negatively impact the patient-provider relationship, the panelists determined.

“The expert panelists were concerned that the EHR would decrease patient volumes because of increased documentation times during the visit,” stated researchers in the report. “It was also felt that the patient’s experience was affected by reduced face-to-face times because the physician was concerned with data entry as opposed to focusing on the patient.”

To mitigate issues surrounding the propensity for EHR documentation to dominate a physician’s time, experts suggested bringing medical scribes into small physician practices to shift the burden off physicians.

“Physicians may need to consider positioning the medical scribe as a permanent part of the medical practice,” stated researchers. “Medical scribes can assist in the inputting of data, which could increase efficiency. This setup could potentially increase the number of patients seen as well as increase physicians’ face-to-face time with patients.”

Apart from the potential for EHR documentation to eat up a physician’s workday, experts also expressed concern over the excessive costs and technical challenges brought on by EHR adoption. These factors impose a strain on small practices that experts believe could result in practice closure.

“Panelists stressed the concern over the loss of the small physician practice, although it did not rank high on the list of the most common concerns,” wrote researchers. “Another panelist also mentioned having recently left a small practice for a larger one for financial concerns.”

With little guidance from vendors on how to realistically achieve positive patient outcomes, physicians in small practices have a generally low opinion of EHR technology.

“This study suggests that attitudes surrounding the EHR are less than positive, with many physicians in small practices experiencing grave concern about the future of their practice,” stated researchers.

To redeem a positive reputation in the eyes of small practice physicians, experts suggest EHR vendors provide more education and training options to physicians to ensure these practices have the best chance of optimizing the technology efficiently.

“The results of this study indicate an avenue for EHR vendors to develop educational avenues to teach physicians how to optimize the EHR as well as to share success stories that demonstrate improved financial impact,” wrote researchers.

Experts determined that concerns regarding a reduction of patient volume and a decrease of face-to-face provider-patient interaction could both stem from inexperience and inefficiency on the part of providers who are not fully comfortable operating EHR technology.

Vendors should develop programs to train small practices and conduct studies proving EHR use in well-trained physician practices results in positive outcomes, experts said. This could also improve overall physician opinions regarding EHR use.

“Vendors should consider developing specific training aimed at small physicians and presenting case studies showing positive outcomes,” stated researchers. “Vendors will need to accept that small physician practices may need specialized training because the practices will likely not have the resources to hire an expert to optimize the system.”

Government incentives pushing for the use of EHR systems will be helpful in implementing systems among small physician practices. 



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