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Mastering EHR after Rollout Is Key to Productivity Gains

Written by Kaitlyn Houseman | August 2, 2012

The fear of lost productivity — as in seeing fewer patients — ranks as a major barrier to implementing an electronic health record (EHR) system, yet among healthcare groups that have mastered their use, productivity is far more likely to rise than fall, according to a new survey by the Medical Group Management Association (MGMA).

The MGMA survey distinguishes between groups that have merely implemented an EHR system and those that have "optimized their use." The survey does not define optimal use, but to James Margolis, an MGMA senior project manager, the term suggests a range of accomplishments: exploiting all, not some, of the software tools available; reorganizing work routines around these tools; and connecting the EHR to other healthcare computer systems and digitized medical devices.  The term also describes EHR adeptness across the entire staff.  "Everybody is up to speed," said Margolis. "They can find the right screen in a second."

The survey of 4588 healthcare organizations, 59.2% of them independent medical practices, points to one big reason why some EHR users fail to get their money's worth from the technology. Among EHR owners, 53.2% either mildly or severely underallocated enough time for training, with the demands of patient care competing for clinicians' attention.

More Hands-On Training, Less Power Point

For healthcare organizations still in the paper chart world, worries about lower productivity during the transition to an EHR system is the most cited barrier to switching over, at 78.3%, whereas lost productivity after the transition ranks third, at 67.4%. In between is concern about insufficient capital to invest in a system, at 71.7%.


The Center for Medicare and Medicaid Services is addressing the capital issue with its program to give 6-figure incentive payments to physicians who demonstrate that they use EHRs in a meaningful way; that is, to improve the quality of care and lower costs. Eight of 10 groups that use an EHR for most of their patients told the MGMA that they will attempt to qualify for those incentives.

Once practices go digital, they tend to be happy about it, according to the MGMA survey. Almost 72% of the practices surveyed reported being satisfied or very satisfied with their system, and almost as many felt that way about its ability to integrate with their billing software, improve patient care, and enhance patient safety.

The picture is less rosy when it comes to the effect of EHRs on the livelihood of providers. Among groups that had implemented a system but not yet reached the optimal use stage, physician productivity decreased for 30.6%, increased for 26.5%, and remained the same for the rest of the groups. Likewise, 38.4% of groups reported an increase in practice operating expenses compared with 25.9% posting a decrease.

The opposite held true for groups that had shifted into high gear with digital charts. Physician productivity increased for 41.1% of them, decreasing for only 16.5%, and operating costs declined for 39.7% and increased for 26.8% of these groups.

The survey sheds light on how to improve EHR training, which in turn might bring about EHR mastery and its benefits. Respondents suggested more hands-on training with the system, as opposed to "presentations on a screen"; separate classes for physicians, nurses, and nonclinical staff that focus on the software functions they use every day; and training that is closer to the system's go-live date.

From Medscape Medical News

by: Robert Lowes