Small Practices Less Likely to Fully Utilize Their EHRs

By Scott E. Rupp via Multibriefs

A recent Black Book Research report has shown that almost 90 percent of practices with six or fewer practitioners are not properly using advanced electronic health record (EHR) features like electronic messaging, clinical decision support, interoperability, data sharing and even patient engagement processes. The Black Book survey is no small sample set, either, with almost 19,000 EHR users surveyed for the report.

Furthermore, 93 percent of all medical and surgical practices with an installed, functional system are using the three basic EHR tools frequently or always, including data repository, order entry and results review.

"Traditionally, it’s been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications, but we confirmed also that the smaller the practice, the less likely they are to use advanced IT tools and that is where EHR frustration among small practices is generally focused," said Doug Brown, managing partner of Black Book, in a statement.

Per the company’s release on the survey, the "majority of larger practices use advanced features frequently, and 30 percent of practices with 11 or more clinicians said they expect to replace their current EHR system by 2021."

Larger practices also are better positioned to implement new IT tools, but many that are eying new technologies seem to have taken a "wait and see" approach before replacement, regarding some of the “posturing of the major suppliers of solo physician practice systems in states of change, including Practice Fusion and eClinicalWorks, with both claiming more than 93 percent customer loyalty positions in Q1 2018.”

"So when we look at apples-to-apples client satisfaction among small practices, it's about basic functionality experience," said Brown. "While in large practices, the rating of customer satisfaction is based on that plus a much wider breadth of vendor offerings and client execution from claims management to population health bundled in."

Another study this year by Black Book found that healthcare consumers identified that 91 percent of patients under 50-years old skew toward digitally based practices, “particularly those with advanced features, connectivity with other providers and comprehensive portals” to give them access to managing their health via phones and devices.

"The technology expectations of upcoming generations will likely then contribute to the gradual demise of independent, solo physician practices if they do not invest and provide what healthcare consumers clearly want," said Brown.

According to the CDC, healthcare specialists have higher adoption rates than general and family practices of such technology. A CDC survey in 2017 showed that office-based cardiologists, neurologists and urologists have the highest adoption rates.

Another previous Black Book survey found that cloud-hosted EHR options are finding a place in practice, and are potentially great for small practices, and the reason for the selection of such is price – about 80 percent of small practices cite pricing as the main factor in selecting a cloud EHR.

Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.


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