The recent release of the AmericanEHR Partners research report, Physicians Use of EHR Systems 2014 prompted a number of media responses, one of which questioned the process and methodology by which the data was collected from target populations in conjunction with professional society partners.
In order to respond to the question of survey populations, I would like to provide a summary of the survey oversight and governance process as well as a more detailed explanation of the methodology that AmericanEHR uses to conduct EHR surveys.
- AmericanEHR Partners is a vendor neutral eHealth data organization that has been collecting information around EHR systems for over 5 years. Over 5,800 verified clinicians surveys have been completed since the launch of the site in 2010. All of the data collected is free for physicians and professional associations. AmericanEHR Partners does not endorse any products or services. The program provides ratings on certified EHR systems. Ratings are based primarily on surveys of physicians conducted through their professional societies. Ratings are displayed on all EHR vendors regardless of their participation in the program.
- Ratings are only displayed once a minimum number ‘n’ of survey responses have been received; the current minimum value is ten ratings. The rating scores are aggregated from the relevant questions asked on the physician user surveys, and these questions are available to the public. The ‘n’ is presented for all product ratings to assist the user when interpreting the rating data.
- From time-to-time, AmericanEHR Partners develops reports (such as Physician Use of EHR Systems 2014) based upon the data collected.
- AmericanEHR Partners has a stringent governance process. Four advisory groups have been established to provide feedback on the AmericanEHR Partners program. These are: Physician Advisory, Professional Society Advisory, EHR Vendors Advisory and a Healthcare Stakeholder advisory that includes national organizations not represented in the first three advisory groups.
- All professional society participants, automatically have a seat on the society advisory group. The purpose of this advisory board is to guide AmericanEHR from a specialty and subspecialty perspective and to provide guidance on education, collaborative initiatives and future development in relation to specialty and subspecialty physician groups.
Survey sample selection
When conducting a survey in conjunction with a professional society partner, for example the Physician Use of EHR Systems 2014 report, a randomized sample of members from each participating organization are surveyed. As the professional society partners are regularly surveying their members on a variety of topics, and in order to prevent over-surveying, each provides a random sample of members with active email addresses in order to conduct the AmericanEHR survey. Each survey group receives an initial invitation to complete the survey as well as 1-2 reminders. Because the sample is selected randomly from the member database, we expect that some individuals will not be using EHRs. These individuals are excluded in the survey registration process. While it is desirable to be able to survey an entire professional organization’s membership, this is not possible due to the number of additional surveys that each organization conducts of their members as well as the issue of survey fatigue.
Prior to collection of data for the Physician Use of EHR Systems 2014 report, an extensive review process was undertaken to update the AmericanEHR survey in conjunction with the American Medical Association, American College of Physicians and the American Academy of Family Physicians. In particular, AmericanEHR worked with AMA Market Research staff to formulate new questions designed to examine the economic impact of EHR use and the role of scribes. In order to keep the overall length of the 2014 survey at its current level, AMA and AmericanEHR agreed to eliminate questions that were not effective and/or addressed in other parts of the AmericanEHR 2013 survey.
When the 155 question survey is conducted, all physicians are verified either directly in conjunction with their professional society through a verified sample, against the AMA Physician Masterfile or in limited situations through a manual process.
Due to the comprehensive nature of the EHR survey, the survey takes approximately 20 minutes to complete. However, the detailed nature of the data collected also provides key insights into the adoption and use of EHR systems by clinicians in varying practice sizes and by specialty.
We stand steadfastly behind the methodology, process, collection of data as well as the interpretation of the results as presented in our most recent report. In particular, we believe that the ability to survey physicians in conjunction with their professional organizations provides the most relevant and representative information on actual experiences in the use of EHRs.
Dr. Alan Brookstone and Thomas Stringham
Co-founders, AmericanEHR Partners