Clicky

April 24, 2014

Nuance Survey shows that 90% of doctors are “concerned” about usability of EHR

The healthcare industry has been awaiting a formal definition of electronic health record (EHR) meaningful use ever since the language of the HITECH Act within the American Recovery and Reinvestment Act of 2009 (ARRA) was made public. According to the HIMSS Electronic Health Record Association, the federal government is expected to publish criteria pertaining to the definition of meaningful use as early as this week. In anticipation of definitive criteria, Nuance Communications, Inc., a leading supplier of speech solutions that help clinicians with the transition to and utilization of EHRs, engaged physicians via survey to better understand how “meaningful use” should, from their point of view, ultimately be defined. Today, Nuance is announcing results from the EHR Meaningful Use Physician Study, which represents feedback from more than 1,000 physicians throughout the United States.

EHRs have been recognized as a core component to national healthcare reform. Beginning in 2011, physicians and hospitals can receive incentive payments under Medicare and Medicaid, but only if they are found to be “meaningful EHR users.” The EHR Meaningful Use Physician Study was meant to explore and measure physicians’ opinions related to the value of the EHR from an adoption, feature-set, productivity, patient care and cost benefit value perspective.

When asked about qualifications that the federal government should measure as part of pay-outs associated with EHR meaningful use, physicians cited the following as “important” or “very important”:

  • Access to medical records faster without waiting for records to come out of traditional manual transcription (90 percent)
  • More complete patient reports, with higher levels of detail on the patient’s condition and visit (83 percent)
  • Better caregiver-to-caregiver communication based on improved reporting that is more accessible and easily shared (83 percent)
  • Improved documentation by pairing the EHR point-and-click template with physician narrative (79 percent)

In addition to gaining insight that physicians value readily available, highly detailed electronic medical records as most merited for government reimbursement, the study also shed light on physicians’ concerns surrounding existing obstacles to EHR adoption. In fact, 90 percent of doctors surveyed said they are either “concerned” or “very concerned” about usability as a leading obstacle to EHR adoption. Following usability, issues related to cost, learning curves of a new system, increased time documenting care, and inability to use dictation to create medical notes were also identified as obstacles that need to be addressed.

“Utilization, actually getting physicians and healthcare provider organizations not just to deploy an EHR system, but to effectively use it for clinical documentation, remains a leading and often overlooked hurdle to national EHR adoption,” said Peter Durlach, senior vice president of marketing and product strategy, Nuance Healthcare. ”By speech-enabling the EHR many common EHR obstacles can be avoided. Speech recognition can help to decrease the time it takes to document care and eliminate sole reliance on the keyboard and mouse. Speech recognition enables clinician to create electronic health records in the most efficient way possible – by speaking, a workflow they are accustomed to and prefer.”

By eliminating physicians’ sole reliance on typing, clicking and scrolling, something that 67 percent of doctors surveyed cited as a concern (“time associated with reliance on keyboard and mouse to document within an EHR”), healthcare providers can allocate more time toward patient care instead of reporting. Because most doctors speak at least three times faster than they type, speech recognition software can improve physician productivity by up to 25 percent, as compared to a non-speech-enabled system.

Productivity tools that would help doctors to better document care within an EHR (beyond the keyboard and mouse) were cited by 75 percent of the doctors surveyed as an incentive to EHR adoption; whereas 69 percent cited “stimulus money.” Additionally, a medical record that combines point-and-click EHR templates with dictated physician narrative promotes ongoing higher quality care via complete and patient specific information that clearly articulates the unique story of every patient encounter. Nuance believes, as does 91 percent of physicians surveyed who either “agree” or “strongly agree,” that EHRs are only as valuable as the data that is captured and made available in them.

Comments

  1. Tim Thurston says:

    We have resisted adding voice to our EHR due to adding another tech layer but may reconsider.

  2. I suspect you're not alone. Adding voice is a huge additional layer,
    especially if what you're already doing is working. Practices that try and
    change everything at once are extremely ambitious. Thanks for your
    comment.

  3. We had used voice as an add-on to our EMR (commercial voice recognition works fine with most systems), but found that it actually slowed practitioners down compared with well-deisgned brief templates. Voice notes were more narrative, longer, with “perfectly spelled nonsense” peppered throughout. We now use a combination of quick, modifiable templates and brief typing, which moves us along quite well.

  4. Thanks for the information. It really sounds like you've got a great
    solution going now. I like you term “perfectly spelled nonsense”. Do
    you do all of the typing in-house now or do you send any out to a
    medical transcriptionist? If you do send any out do you have a sense
    of how much less you're sending out after implementing your EMR system?

  5. We don't use transciptionists – too long of a lag time between dictation and document-in-the-chart (plus the cost). That's why we used speech recognition in the first place – to replace the transcriptionist. We have a PA who still uses speech recognition (we used IBM Via Voice) some, but is migrating away from it, and I abandoned its use a few years ago. We used a customizable templating system (where common sentences used in notes of various types cab be selected in user-customizable templates) in an EMR system called Medical ChartWizard, which later was acquired by Practice Fusion (disclosure: I was brought on by Practice Fusion as Chief Medical Officer at that time, though I maintian a clinical practice) – the same approach to templating is used in Practice Fusion. This is a different approach from the stiff, template-centric EHRs I have seen on the market, which really do tend to slow a practitioner down.

  6. Thanks, one of the great mysteries of the EMR conversion process to me
    involves the process of getting the physicians notes into the system.
    I appreciate you sharing the path you've taken.

  7. Tim Thurston says:

    Something inherent in all of this is being able to retrieve from many different perspectives the information that you have entered. The more individualized the information entered, the less comparable it is from patient to patient and the less easy it is to put that into any type of manageable information for data analysis. The terminology used by physicians is so diverse that using a system that encourages diversity makes much of the information not mineable for future analysis. Just another perspective.

  8. eric1450 says:

    As a vendor of Dragon Medical, you may readily consider my opinion as colored by that fact. Having said that – I have seen Dragon work in a variety of of EHRs.

    You may be interested in a variety of videos we've produced demonstrating how Dragon can be utilized within certain EMRs, and let the pictures speak for themselves.

    http://www.1450.com/dns/emrvideos/

    Yours,
    Eric

  9. eric1450 says:

    As a vendor of Dragon Medical, you may readily consider my opinion as colored by that fact. Having said that – I have seen Dragon work in a variety of of EHRs.

    You may be interested in a variety of videos we've produced demonstrating how Dragon can be utilized within certain EMRs, and let the pictures speak for themselves.

    http://www.1450.com/dns/emrvideos/

    Yours,
    Eric

Trackbacks

  1. [...] ONC and healthcare IT in general is stirring about the words “meaningful use” I find a survey by Nuance that shows that 90% of doctors are “concerned” about the usability of [...]

  2. [...] Other issues of concern to the physicians surveyed include cost, time lost during training, and not being able to use existing dictation routines to create medical notes. See the full report. [...]

  3. [...] fail if they don’t adopt the technologies? To be fair, there is a small group talking about a role for usability in these discussions, but it is a still a small part of the [...]

  4. [...] fail if they don’t adopt the technologies? To be fair, there is a small group talking about a role for usability in these discussions, but it is a still a small part of the [...]

Speak Your Mind

*