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.