A 2013 RAND study sponsored by the American Medical Association (AMA) identified a number of issues related to physician use of electronic health record (EHR) systems. The report, entitled “Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy”, noted that for many physicians current EHR functionality has led to professional dissatisfaction. To better understand the factors that are driving this professional dissatisfaction the AMA engaged AmericanEHR to conduct a revised version of AmericanEHR’s annual survey examining physician use of EHR systems.
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.
As part of the process to create the new questions, AMA staff also consulted with the Medical group Management Association (MgMA). MgMA has extensive experience examining the finances of medical practice including the use of EHRs.
AmericanEHR Partners uses a 155-question online survey to collect data on clinicians’ (Physicians, NPs, and PAs) use and satisfaction with EHRs and health information technology. The survey uses skip logic to present individuals with questions that are most relevant to them, and takes an average of 20 minutes to complete. Respondents are allowed to skip questions or indicate that they do not know the answer to the question. The core survey has been in use since 2011.
The results presented in this report were collected through surveys conducted by AmericanEHR Partners in conjunction with the American Medical Association, American College of Physicians and American Academy of Family Physicians between May 30, 2014 and July 18, 2014. Each society was allowed to select the population of their members to receive the survey. Information about EHR use by individual society members was not available. Therefore, the survey went to both users and non-users of EHRs. All respondents completed the same survey. Recipients were able to opt-out of receiving any additional survey reminders. Survey respondents were asked to verify selected user information prior to beginning the survey and were then prompted to create a user account in order to allow for saving and updating of responses prior to submission of the completed survey.
The target completion rate was 1,000 responses. 940 completed surveys were received. A total of 36,318 physicians received invitations to complete the survey (AMA – 18,000, ACP – 13,616 and AAFP – 4,702). The average response rate was 2.6%, though rates differed across professional societies. This observation may reflect, in part, the variable accuracy of the email addresses collected by the societies and the fact that we did not know who was and was not an EHR user. The relatively low response rate should be taken into account when interpreting the results of this report.
The 51 page report is divided into nine (9) sections including an introductory section:
- Sections 2 and 3 present a profile of the physicians who responded to the survey and the EHR systems that they use.
- Sections 4 to 7 explore the survey results. Each section examines a particular theme or related group of questions.
- Section 8 offers insights about and interpretations of the survey data.
- Section 9 examines the implications of the survey results.
Some key findings on the impact of EHR systems on practice:
- 42 percent thought their EHR system’s ability to improve efficiency was difficult or very difficult.
- 72 percent thought their EHR system’s ability to decrease workload was difficult or very difficult.
- 54 percent found their EHR system increased their total operating costs.
- 43 percent said they had yet to overcome the productivity challenges related to their EHR system.