Posted in EHRs

Failure of ambulatory care practices to fully utilize EHRs hurts healthcare system, study says

Chris Nerney
Chris Nerney, Contributing Writer |
Failure of ambulatory care practices to fully utilize EHRs hurts healthcare system, study says

Nearly three-quarters of ambulatory care practices in the U.S. aren’t taking full advantage of available health information technology functionalities, undermining efforts toward coordinated and more efficient care.
That’s the conclusion of a study published last Friday in the American Journal of Managed Care. Conducted by a team of researchers in California and New Zealand, the study examined how frequently ambulatory care practices across the U.S. used electronic health record (EHR) health information technology functionalities.
While noting that “practices restricting themselves to the more basic features of this technology may limit the potential impact of the EHR on their own performance,” researchers argue that “under-use of health IT in ambulatory care has implications for the ability of the health system as a whole to provide coordinated and efficient care.”
Using data from a 2014 HIMSS ambulatory practice survey, the researchers broke EHR health IT functionality into seven “domains” – data repository, clinical decision support, order entry management, electronic messaging, results management, health information exchange, and patient use.
Researchers found that among more than 30,000 practices responding to the HIMSS survey, only 27 percent were considered “super-users,” defined by the study team as “maximally using EHR functionalities designed to improve patient care and facilitate high-quality performance across the broader health system.”
“Of concern was that nearly 40 percent of ambulatory practices were categorized as under-users, indicating minimal use of the EHR and associated health IT functionalities,” the study said.
More specifically, the study’s survey analysis shows:

  • Among practices with use of computerized physician order entry, only 35.6 percent used this function for more than 75 percent of orders.
  • More advanced functionalities (such as finding and modifying orders for all patients on a specific medication) were used even less frequently (29.3 percent).
  • Basic EHR functions such as data storage were more commonly used, with 100 percent of respondents electronically storing transcribed reports, and 61 percent using their EHRs to store nursing documentation.

The study cited several barriers preventing ambulatory practices from fully utilizing EHRs and health IT, including cost, lack of IT expertise, and infrastructure issues. Researchers recommended that policy-makers “consider how to address the barriers of the small, nonmetropolitan, and specialist practices to using their health IT functionalities more fully, as the relative under-use of these tools has far-reaching implications.”
 “Facilitating the full use of a range of health IT tools in the ambulatory setting may help the broader health system gain the full benefit of investments in EHR-based technologies,” they wrote.