Research Activities, September 2013
Study outlines physicians’ difficulties in transitioning from older to newer electronic health records for e-prescribing
Health Information Technology
Federal health policy initiatives are promoting the adoption and meaningful use of certified electronic health records (EHRs) with electronic prescribing (e-prescribing) in order to improve the safety, quality, and efficiency of health care delivery. As a result, many institutions and providers currently using locally developed EHRs will likely be transitioning to newer, commercial EHRs to ensure that their systems meet certification standards that make them eligible for incentive payments. A new study reveals that some physicians consider the transition very difficult, despite the customization, training, reduced schedules, and pre-transfer of medical data. Many physicians felt that their efficiency was significantly reduced, even well after the initial transition.
The researchers studied the challenges associated with the transition to commercial EHRs when a large ambulatory care network at an academic medical center switched from an older EHR to a newer, commercial EHR with a more robust clinical decision support (CDS) to aid providers in the prescribing process. The researchers conducted field observations and interviewed 19 physicians involved in the process. Although a few features of the newer commercial system were highly valued, such as the ability to access the system remotely and to have shared medication lists with subspecialists, the majority of physicians preferred a much simpler system.
Most physicians in the study did not perceive the commercial EHR as better able to decrease prescribing errors, even though it had the capability to provide more robust CDS. Although some alerts were perceived as useful, the benefit was often lost because of the high volume of clinically irrelevant alerts. Understanding physician experiences with this type of transition and their general preferences for prescribing applications may lead to less disruptive system implementations and better designed EHRs, suggest the researchers. Their study was supported by AHRQ (HS17029).
See "Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing," by Erika L. Abramson, M.D., Vaishali Patel, Ph.D., Sameer Malhotra, M.D., and others in the International Journal of Medical Informatics 81, pp. 539-548, 2012.