Small-practice physicians who use electronic health records (EHRs) firmly believe in the technology's transformative capabilities, according to survey results released Oct. 3. Survey respondents -- predominately primary care providers who work in practice settings that include 10 physicians or less -- believe that the electronic exchange of health information will have a positive impact on improving the quality of patient care, coordinating care, meeting the demands of new care models, and participating in third-party reporting and incentive programs.
The American College of Physicians (ACP), the Bipartisan Policy Center and Doctors Helping Doctors Transform Health Care developed the survey and analyzed 527 responses in the report titled Clinician Perspectives on Electronic Health Information Sharing for Transitions of Care.
"The exchange of patient health information across care settings is a critical component to the success of the new models to improve care, such as the patient-centered medical home," said Michael S. Barr, MD, FACP, MBA, who leads ACP's Medical Practice, Professionalism & Quality division, in a news release. "ACP agrees with the 78 percent of survey respondents who believe that exchanging health information will have a positive effect on clinicians' ability to meet the demands of these new care models."
Yet challenges remain for the widespread electronic exchange of health information. More than 70 percent of clinicians surveyed identified lack of interoperability, lack of an information exchange infrastructure, and the cost of setting up and maintaining interfaces and exchanges as major barriers that can prevent clinicians from exchanging information with others.
"The Office of the National Coordinator for Health Information Technology has done a lot to encourage the development of the technology needed to support the exchange of information across care settings, but we still have a long way to go," added Barr. "These gaps are most apparent when we look at the infrastructure, or lack thereof, needed to support the exchange of information and the governance surrounding such exchange."
Additional key findings from the survey include:
- Access to medication lists and relevant laboratory and imaging test results are commonly recognized as high priorities for transitions of care.
- More than half of respondents prefer that information they view as "essential" get "pushed" to them, with the ability to access the rest of the information through a query.
- A clear majority of clinicians consider "within 24 hours" a reasonable timeframe for the exchange of information when a patient requires follow-up care or is being treated for an urgent problem.
- When updating the EHR with information received from an external source, clinicians prefer to be able to selectively choose the information they want integrated.
"By categorizing clinicians' views on the types of information they want to receive, how they want to receive it, how quickly they want to receive it, and what they want to do with it, we can support efforts to facilitate the exchange of health information," Barr noted.
The survey was fielded by AmericanEHR Partners, founded by ACP and Cientis Technologies to provide information to support clinicians in the selection and use of EHRs; the American Association of Medical Directors of Information Systems; the American College of Surgeons; and the American Academy of Pediatrics.