Electronic medical records (EMRs) enhanced patient care and increased
patient safety for the majority of health care professionals who responded to
an annual survey of EMR use.
The annual survey of 819 health care physicians and other health care
professionals by the Medical Records Institute (MRI)—a Boston-based
group that advocates greater digital record use in health care—included
two-thirds who identified themselves as having final or strong influence in
EMR decision making. The MRI survey of 20 questions focused on areas such as
strategic information technology priorities, factors driving adoption of EMRs,
and major barriers to implementing EMR systems.
The most frequently cited barriers to EMR implementation were a lack of
adequate funding or resources, anticipated difficulties in changing to an EMR
system, and difficulty in creating a migration plan from paper to electronic
documentation and recordkeeping.
Continued resistance to the use of EMRs by health care workers also was
cited. Nearly one-third of respondents worked with an electronic record system
that some colleagues refused to use.
For respondents who were able to get past those obstacles to EMR adoption,
the technology appeared to have a large impact. More than two-thirds of
respondents said the quality of care patients received had improved since
adoption of EMRs in their organization. More than 90 percent also anticipated
that the digital records would continue to improve the quality of care their
patients receive over the coming 10
The safety impact also appeared significant. Three-quarters of respondents
said patient safety was already improved by EMRs that their organizations have
put in place. Again, more than 90 percent anticipated that EMRs would continue
to improve patient safety over the next 10 years.
Further, the delivery of health care services has improved with the
movement away from paper records. The majority of respondents reported that
the efficiency of health care in their organization was improved by EMRs.
The adoption of health information technology by health care professionals
is being driven by the need to improve clinical processes and work flow
efficiency, according to the survey. The leading drivers for hospital use of
EMR systems are a desire to improve patient safety, increase efficiency and
convenience, and obtain the satisfaction of their physicians and"
clinician employees." Medical practices are driven to adopt EMRs
by a desire to improve patient-care documentation, improve efficiency and
convenience for physicians, and allow remote access to patient
The most-used EMR "data capture" applications were those that
tracked patient demographics, allergies and adverse reactions, and laboratory
results. The least-used applications included pre-visit health-screening
features and post-visit patient-education components.
The findings of this survey reflected conclusions reached by other research
on clinicians' use of emerging digital record-keeping technology, according to
Joy Grossman, Ph.D., senior researcher for the Center for Studying Health
System Change (HSC).
A national study by the HSC reported in September that practice setting and
size were the strongest predictors of the availability of clinical information
technology to physicians. However, different types of clinicians had
significant variation in their information technology adoption
(Psychiatric News, October 19).
"The survey was fairly consistent with studies we have done on the
functionality that is valued by physicians," Grossman said, about EMRs'
ability to track drug interactions.
Her research has indicated t hat increased convenience is a major factor
driving more physicians to use EMRs. The survey-identified barriers to
adoption—cost, anticipated difficulties in switching, and migration-plan
challenges—also reflect what previous research has found.
The survey revealed another factor pushing more physicians to adopt
EMRs—the anticipation of the Centers for Medicare and Medicaid Services'
(CMS) moving toward pay-for-performance systems, Grossman told Psychiatric
News (see CMS Physician Quality Reporting Initiative: Changes for
In the survey analysis, physicians with access to information technology
for all five clinical activities were considered to have an EMR.
The ninth annual MRI survey also affirmed trends from previous years,
including an increased use over the prior year of EMRs for e-prescribing in
hospital settings, where its use by nurses and other staff continues to exceed
physician use. Use of the Continuity of Care Record, which is a standard
patient health summary that can be sent between health care providers, also
has increased since 2006.
Despite the challenges of adopting EMRs, few reported abandoning the
effort. Less than one-fifth of respondents reported deinstallation of one EMR
system to replace it with another, and less than one-tenth reported
deinstallation to revert to paper records.
Information from MRI's 2007 Survey of Electronic Medical Record
Trends and Usage is posted at<www.medrecinst.com/MRI/emrsurvey.html>.▪