Since 2011, the Deloitte Center for Health Solutions has conducted a nationally representative survey of US physicians asking about their perspectives on electronic health records (EHRs). The latest findings show that physician perspectives on EHRs have not changed much through the years – EHR technology continues to underdeliver on its lofty promises. As EHR technology is now widely adopted, many health systems are trying to optimize and realize the benefits of this expensive investment.

The Deloitte 2018 Survey of US physicians sheds light on opportunities for EHR optimization activities to better meet physician expectations.

Although physicians are an important health care stakeholder, the survey results suggest that at best, they perceive themselves as passive participants in EHR optimization efforts, and at worst, they feel ignored. Furthermore, research by others identifies a direct link between EHR and physician burnout.

Physicians note the lack of interoperability and the burden of documentation as top areas of concern with EHRs.

• 62 percent and 58 percent desire changes in the interoperability and documentation, respectively, to their current EHR system (Figure 1).
• In an open-ended question about one daily task that could be done more efficiently, 36 percent note documentation-related tasks.
• Just one-third of physicians say their organization or EHR vendor sought their feedback on EHR enhancements.

Figure 1: As in 2016, interoperability and ease of use are big EHR pain points according to physicians
Survey question: To deliver better care, what changes would you make to the current EHR system at your primary work setting?
 

Physicians report issues with EHR such as time lost, lack of interoperability and misunderstanding as to the value of this data in improving their practice.

While the EHR industry has been able to give us granular level reporting and identify patterns of care that we have not had before, the physicians we work with still complain about the complexity and time lost on income from patient visits because of EMR mistakes and or time consuming data entry that they would like to delegate. While they see value in having data points and benchmarks as well as reminders to meet checklist obligations they really do not use data the way the vendors intended, so there is a large GAP between use and understanding.

The other side of this is the proliferation of EMRs by specialty and location. Some states have dominant EMRs while other health systems report 45 EMRs being used to gather information for their clinically integrated network (CIN) or ACO. This presents the problem of interoperability between systems, and gaps between practices in trying to establish benchmarks and guidelines.
Add to this the many EMRs who integrate patient appointments and billing and what was supposed to be a tool becomes a burden to many physicians until they realize the value of this data for their own purposes. Reviewing summary data can help improve their practice work flow as well as help them look at pricing and intensity of service which can help to actually see how their payer mix and patient age and gender has changed their practice over time.

While there are probably no single solutions to any of these issues in the near future, there are industry and government resources being researched to make interoperability improvements. Many physicians see the negative side of the business because it is very different than what they did in the past, however new physicians coming out of school are seeing the structure and organization of the EMR to be an advantage in starting their practices. So while EMRs are here to stay, we see the next generation of EMRs to perhaps be a bit more user friendly and perhaps will be seen more as a business improvement tool versus just a compliance and reporting obligation