Survey: EHR a tough sell

Despite recent talk about the benefits of electronic health records (EHRs), many medical group practices in the United States have no plans to install such systems, according to a new survey.

Smaller practices are especially resistant to the idea of spending the time and money needed to install EHR systems, according to a study of 3,300 medical group practices, conducted by the Medical Group Management Association Center for Research and the University of Minnesota School of Public Health.

Among practices that employ five or fewer full-time physicians, more than half say they have no plans to adopt HER systems. In contrast, only one-fifth of practices that employ 21 or more physicians are opting out.

The survey shows that a lot more work needs to be done for EHR adoption to be successful, and "small to medium size medical group practices will need more help then they are getting now," said Terry Hammons, senior vice president for research and information at the center.

The study also reports a widespread dissatisfaction with the design and performance of EHR technologies.

The study found that:

* Only 14.1 percent of all medical groups currently use an EHR, with 11.5 percent having fully implemented one for all physicians at all practice locations.

* Only 12.5 percent of practices with five or fewer full-time equivalent (FTE) physicians have adopted an EHR. Those with six to 10 FTE physicians reported a 15.2 percent adoption rate, and those with 11 to 20 FTE physicians were at an 18.9 percent adoption level. Practices with 21 or more FTEs had a 19.5 percent rate.

* 41.8 percent of all practices said they had no immediate plans for EHRs, with 47.8 percent of those with five or fewer FTEs reporting that compared to just 20.7 percent with 21 or more.

* More than 97 percent of respondents with EHRs said they included functions for patient medications, prescriptions, patient demographics and visit/encounter notes.

* Less than 65 percent reported that their EHRs provided drug formulary information or clinical guidelines and protocols, while 83.1 percent had an EHR integrated with a billing system.

The study clearly showed that many group practices still don't see the return on investment of EHRs in terms of cost and quality, said John Kralewski, a professor in the university’s School of Public Health's Division of Health Services Research and Policy.

In many cases, people who have not implemented EHR systems said they either could not afford the systems or they were not convinced that the technology would improve the performance of their practices.

The study found that the average purchase and implementation cost of an EHR was $32,606 for each FTE physician in a practice, with ongoing maintenance costs of $1,500 for each FTE.

It also found that the average cost of implementation was about 25 percent higher than initial vendor estimates.