Promoting Quality & Safety in Oncology Electronic Health Records
EMR Use Growing Among Physicians
Report: EMR Use Growing Among Physicians
A recent survey of office-based physicians conducted by the National Center for Health Statistics (NCHS) indicates that 38.4 percent of respondents use a full or partial electronic medical record system while about 20 percent used a minimally functioning system. Results from this study in 2006 indicated that 29.2 percent of respondents were using a full or partial EMR system and 12.4 percent were using a minimally functioning system. The complete press release is attached.
Source: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/physicians08/phy...
My sense is that oncology practices are adopting EHRs at a rising clip -- though I am not aware of any systematic survey OR data to get a handle on the adoption rate among oncologists.
Do you have a sense of oncologists in your area – do you see more adopting EHRs?
Have you made a recent decision concerning an EHR – pro or con?
Has the current economic environment affected your plans?
Lastly, do you have any comments concerning the usefulness of ASCO resources in your decision process for an EHR?
A recent survey of office-based physicians conducted by the National Center for Health Statistics (NCHS) indicates that 38.4 percent of respondents use a full or partial electronic medical record system while about 20 percent used a minimally functioning system. Results from this study in 2006 indicated that 29.2 percent of respondents were using a full or partial EMR system and 12.4 percent were using a minimally functioning system. The complete press release is attached.
Source: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/physicians08/phy...
My sense is that oncology practices are adopting EHRs at a rising clip -- though I am not aware of any systematic survey OR data to get a handle on the adoption rate among oncologists.
Do you have a sense of oncologists in your area – do you see more adopting EHRs?
Have you made a recent decision concerning an EHR – pro or con?
Has the current economic environment affected your plans?
Lastly, do you have any comments concerning the usefulness of ASCO resources in your decision process for an EHR?
- Attachments:
-
-
physicians08.pdf, 37 KB
-
Replies to This Discussion
-
Permalink Reply by Robert S. Miller, MD on -
Interesting that the numbers were much less robust in the recent widely-cited ONCHIT-sponsored study in NEJM (DesRoches CM, Campbell EG, et al. Electronic health records in ambulatory care – A national survey of physicians. N Engl J Med 2008;359:50-60). Here is the link (may just work for NEJM subscribers).
Not aware of ANY oncology data. In my local area, I am not aware of any adoption by oncologists. Economics play a huge role, as do concerns about interoperability, especially if a practice may be bought/merge with another entity.
In another post, I hope to present some thoughts about what ASCO can do. BUT... I am most interested in our members' opinions as to the useful of the current ASCO EHR resources.
-
Permalink Reply by Douglas Blayney, M.D. on -
I recently received results of a survey in which I participated, which was conducted by Oncology Metrics., a "knowledge sharing network." An "online survey tool was used to collect data ...The survey tool was open from August 14 – August 27, 2008. A total of 515 responses were collected from respondents in 47 states. 32 responses were identified as duplicates and were removed. There were 479 responses to the key question in the survey “Do you currently use an EMR?” Information was collected from both EMR users and those that have not yet implemented an EMR."
The results are proprietary, so I can't share. The survey did not define the features of an EMR; the respondents were able to respond as they saw fit. Since the survey was conducted online, and participants were solicited by email, there is considerable selection bias in the result. Interestingly, over 50% of the respondents reported using an EMR.
Oncology metrics has published results of their past surveys in JOP here, here, and here so there may be more information forthcoming. Tanja Sauer (TSauer@oncomet.com) was my contact at Oncology Metrics, and she may be able to supply more information.
-
Permalink Reply by Ed Ambinder on -
Unfortunately, EMRs and EHRs have different definitions and functionalities in the minds of physicians. In addition, even though physicians may have a "complete" EMR/EHR available to them in their practice, many may be using only a small fraction of its full capabilities. It is important for these surveys to define the "product" and query the users about the specific functionalities they use.
-
Permalink Reply by Scott Herbert, MD on -
I think that the surveys need to be taken with a grain of salt. Most oncology practices in our area claim to be "in the process of looking" for an EMR. It's very true, however, that the definitions of EMR/EHR make it difficult to determine what types of systems practices are using. I would be almost certain that most use an electronic office management package but very few use e-prescribing, CPOE, or a chemotherapy ordering suite.
After looking extensively for an EMR, including using the ASCO resources, we decided to build our own software system. The ASCO resources were exceptionally thorough and helpful, but I felt that none of the current systems addressed some specific EMR/EHR problems. While all seemed to be very powerful "super-charts" (data silos) I am still doubtful that many can easily lead to increased communication. Our practice deals with at least 3 imaging centers, 4 laboratories, and we also have a fairly large number of "snow-birds". Building separate interfaces for each of the above and still not improve care of the snow-birds led us away from traditional EMR's. Also, scanning in outside notes from every other provider in our area was a daunting task.
I'm wondering if our current line of thought behind EMR development is actually the right way to go? If we truly want intraoperability, increased communication, and access to huge amounts of data I'm doubtful that the current EMR data silos can provide this. I believe that this may only be accomplished by a web-based system.
-
Permalink Reply by Robert S. Miller, MD on
-
You hit the nail on the head. One of the huge problems with most EHR products currently available is that they do not facilitate communication and collaboration. For example, my practice is considering the implementation of the US Oncology EHR product iKnowMed (we have been on the, ahem, waiting list for several years), which seems to be a reasonably functional oncology-specific product, but is not intrinsically configured, as I understand it, to be very interoperable with the Epic system that one of our local hospitals is using and Cerner used by the other. An EHR is probably better than a paper record in most cases, as painful as the transition may be, but an EHR that is simply an electronic version of the same paper record will always have serious limitations.
The idea of making an EHR more collaborative may require thinking way far out of the box - farther than most vendors are willing to go. Take a look at this post from Dr. Bob Wachter's blog, and the comments that follow. He talks about using Facebook-like features to make the EHR a more practical and less silo'd product. I think the idea of integrating these Web 2.0 technologies into EHR while provocative is right on target.
-
Permalink Reply by Douglas Blayney, M.D. on
-
At the ASCO Clinical Practice Committee meeting on Friday, January 16, as part of his presentation on the EHR Workgroup and the EHR Workshop, John Cox asked those in the room to raise their hand if they and their practices used a fully functioning EMR. Of the approximately 50 people in the room, over one half raised their hands, according to his count. (I thought the number was higher).
Of course, there is some selection bias operating here. The Committee has leaders and early adopters, But the count does give me hope for adoption of EMR and the business and workflow changes necessary.
Now on to the next steps -- getting all of these records to exchange information, and to be used to enhance safety and discover and disseminate best practices.
-
Permalink Reply by Elaine Towle on -
Dr. Blayney mentioned the Oncology Metrics survey in his post of 12/21. Here's a little data from the National Practice EMR Satisfaction & Benchmark Survey. As Dr. Blayney mentioned, there are several limitations that must be acknowledged. First, we did not define the features of an EMR in the survey; respondents were able to respond as they saw fit. And since the survey was conducted online, and participants were solicited by email, there is considerable selection bias in the result.
Given these limitations, it is still interesting to note that 57% of the 479 respondents report that they use an EMR and 61% of EMR users report that they have been using their current EMR for 2 years or longer. EMR use was correlated with practice size based on the self-reported number of full time equivalent (FTE) medical oncologists in the practice and the results, not surprisingly, show increased use of EMR as practices get larger. In this survey, 48% of practices with 1-3 medical oncologists reported using an EMR; that number rises to 82% of practices with 15 or more FTE medical oncologists.
This was primarily a satisfaction survey. The results of the individual satisfaction questions (customer service, timeliness of upgrades, etc.) were generally marginal but interestingly 75% of respondents reported that they would recommend their EMR system to a colleague.
-
Permalink Reply by Kevin Jasas on -
EHR adoption in our Oncology Service has been hampered by the fact we work in a General Hospital which already has many separate systems already in place. An electronic results and CPOE system (iSoft), a separate PACS program (Web1000 from AGFA), Clinic Bookings and chart movement through an archaic DOS based program from 25 years ago (TOPAS), Medical Typing based on Word Documents and multiple small source programs for Oncology and Pharmacy related information.
Bringing in an Oncology Specific EHR into this environment is frought with issues of compatiblilty or having to double enter information in multiple systems. It seems that smaller practices or independant community based services are quicker to adopt fully functional EHR as they have the capacity to start up from scratch. Have any of your EHR Adoptees had similar experiences of trying to integrate into complex existing structures?
-
Permalink Reply by Jamil Khatri on -
In Delaware, so far, our practice is the only one that has a full EMR and we have had it for 2 years now.
The current economy has just pushed us to slow down a little bit in terms of upgrades, interfacing etc.
I strongly feel that it is time that ASCO should host an "EHR-best practice" symposium for current users by partnering with various vendors such as Varian, Centricity etc.
-
Permalink Reply by Robert S. Miller, MD on
-
Hi Dr. Khatri,
Thank you for your comments. Hopefully you will be able to join us for the 2009 ASCO EHR Symposium: Harnessing the EHR, From Incentives to Sustainability, in San Francisco, Oct. 6-7 just prior to the ASCO Breast Cancer Symposium. We hope to address many of these issues.
-
Permalink Reply by John Cox on -
From the ASCO EHR Symposium === I was struck by the informal survey of attendees (queried by speakers from the podium) that most were from small practices, and did not have EHR installed. I suspect that the oncology metrics survey alluded to earlier in this string, reflects larger groups that have adopted the technology. I wonder, in that most oncology practices are small, if the adoption rate is still low (commonwealth fund report in nov of 2009, Health Affairs - est. US adoption 25%) ====>>>>
Mentioned at the Symposia - was the note that vendors have noted a slow down in purchases over the past 2 quarters. This initially struck me as counter-intuitive in light of the ballyhoo of govt monies that will be available for practices who have adopted EHR. It was explained that the uncertainty of which products will be 'certified' and which will meet the still undefined 'meaningful use' criteria has frozen practices' decision processes.
This too will have ramifications. AS these regulatory details will be worked out within the next 6 months; there will likely be a pent up 'rush' to purchase EHRs...... the companies potentially will have a hard time meeting that demand, and many practices may be faced with being placed into a long queue to get the EHR installed. AS the maximum ARRA / HITECH funding is for practices with EHRs in place in 2011..... This may prove to be a challenge.
© 2010 Created by OncologyEHR Administrator.
