Jul-Aug 2014 Table of Contents

FROM THE EDITOR

EHR Dissatisfaction: Is It Time to Switch Your EHR?

A new FPM survey will explore why physicians change EHRs and whether doing so increases their EHR satisfaction.

Fam Pract Manag. 2014 Jul-Aug;21(4):6.

Do you hate your electronic health record (EHR)? Or do you just barely tolerate it? Recent reports suggest that a large percentage of U.S. physicians would answer “yes” to one of those two questions. In 2011, we reported that only 38 percent of family physicians would buy their particular EHR again if given a chance.1 A survey released in February of this year by MPI Group and Medical Economics reported essentially the same thing – 60 percent of family physicians would not purchase their particular EHR again.2

Our 2012 EHR survey discovered that 15 percent of respondents had already changed EHRs at least once due to dissatisfaction.3 A Black Book Rankings survey of nearly 17,000 EHR users in 2013 found that 31 percent would like to change vendors and 17 percent were planning to do so in the next 12 months. They called 2013 the “Year of the Great EHR Vendor Switch.”4

So what's going on here? A 2013 RAND report on physician practice satisfaction found that most physicians feel that EHRs improve the quality of patient care and only 18 percent would prefer to return to paper records.5 Significantly, it found that satisfaction with EHRs is an independent predictor of physicians' overall professional satisfaction.

Yet the RAND study also found widespread discontent with current EHR technology. Physicians lamented about poor EHR usability, time-consuming data entry, interference with face-to-face patient care, and the degradation of the quality of clinical documentation. Interestingly, and perhaps not surprisingly, the study also reported that as the number of EHR functions increase, user satisfaction drops.

All this dissatisfaction and angst caused me to rethink our approach to evaluating EHRs. From 2005 to 2012 FPM published five EHR user satisfaction surveys, and from 2004 to 2013 EHR adoption among U.S. physicians grew from 21 percent to 78 percent.6 EHRs are now an established fact of the health care landscape. Despite widespread dissatisfaction with the current state of the art, users aren't abandoning EHRs. Rather they are changing vendors. Based on the aforementioned reports, that trend seems to have accelerated recently. Many folks are wondering if the grass is greener in another EHR vendor's yard.

We want to learn more about this trend. Who is changing their EHRs? Why are they changing? What EHR are they changing to and from? How hard is it to make the change? What is satisfaction like after the change? Is the grass any greener?

Changing an EHR is a huge undertaking. In this issue, we are conducting a survey of those who have made that leap with the hope that we can help the large percentage of physicians who are considering doing the same. If you have changed to a new EHR since Jan. 1, 2010, please complete the FPM EHR Switch Survey. We'd all very much appreciate learning from your experience – both good and bad.

1. Edsall RL, Adler KG. The 2011 EHR user satisfaction survey: responses from 2,719 family physicians. Fam Pract Manag.2011;18(4):23–30.

2. Medical Economics EHR survey probes physician angst about adoption, use of technology. Modern Medicine website. http://bit.ly/1i1YfP0. Accessed June 16, 2014.

3. Edsall RL, Adler KG. The 2012 EHR user satisfaction survey: responses from 3,088 family physicians. Fam Pract Manag.2012;19(11):23–30.

4. Electronic health record sellers face make-or-break year of client ultimatums and revolts, reveals 2013 Black Book survey. PRWeb website. http://www.prweb.com/releases/2013/2/prweb10416655.htm. Accessed June 16, 2014.

5. Freidberg MW, Chen PG, Van Busum KR, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy. Santa Monica, Calif: RAND Corporation; 2013.

6. Hsiao C, Hing E. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2013. NCHS Data Brief, No. 143. Hyattsville, Md: National Center for Health Statistics; 2014.

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