Large Practices Not Satisfied with EHR Features – Black Book Survey

Recognizing the importance and convenience of electronic health records (EHRs), most physician practices are looking for ways to get more customizable and integrated EHRs, with practice management and revenue cycle management capabilities. According to the latest Black Book Survey of ambulatory EHR products, 30% of practices with over 11 clinicians expect to replace their current systems by 2021 for customization issues. Based on this survey of nearly 19,000 total EHR users, it is reported that majority of hospitals are looking for cloud-based and mobile tools that offer on-demand data and visibility into financial performance, compliance tracking and quality goals. The dissatisfaction with current advanced EHRs points to the continuing relevance of the services provided by experienced medical transcription companies. The electronic health record has to evolve considerably, be customizable and interoperable if physicians are to be totally satisfied with it.


Other key findings of this survey include:

  • 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
  • 93 percent stated that cloud-based mobile solutions for on-demand data was their top priority
  • 87 percent cited tele-health/virtual visit support as their key interest, while 82 percent said they wanted speech recognition solutions for hands-free data
  • Regarding interoperability/record sharing functionalities, 80 percent of single/solo practices said they never or infrequently engage in it; but that number dropped to 59 percent in medium-sized practices and 22 percent in larger practices of 15 or more providers
  • Regarding patient engagement, 84 percent of single practices said they do not leverage these strategies at all or only infrequently; and that number dropped to 38 percent for mid-sized practices, and 9 percent for larger practices of 15 providers or greater

At the same time, this survey points out that 88 percent of small practices of six or less practitioners still aren’t optimizing advanced EHR tools such as patient engagement, secure messaging, decision support and electronic data sharing.

Whether large or small, it is critical for healthcare practices to follow the standard EHR guidelines.

A recent study published in the Journal of the American Medical Informatics Association points out that despite availability of the Office of the National Coordinator for Health Information Technology’s (ONC) SAFER recommendations on how to improve use of EHRs, most recommendations were not fully implemented. The report proves that the healthcare organizations’ adherence to Safety Assurance Factors for EHR Resilience (SAFER) guidelines is low.

In the year 2014, HHS released a series of nine evidence-based tools called Safety Assurance Factors for EHR Resilience (SAFER) Guides that outline best practices for healthcare organizations to implement and utilize electronic health records and reduce the chance of an adverse event.

Each SAFER Guide addresses a critical area associated with the safe use of EHRs. The guides include a series of self-assessment checklists, practice worksheets, and recommended practices for the following nine areas that your hospital or ambulatory practice can utilize to improve patient safety. It identifies recommended practices to optimize the safety and safe use of EHRs.

Based on the risk assessments on 8 organizations of varying size, complexity, EHR, and EHR adoption maturity, it was found that only eight organizations had fully implemented 25 out of the 140 (18 percent) SAFER recommendations. 94 percent of organizations fully implemented System Interfaces, which included 18 recommendations, while 63 percent implemented clinical communication that comes with 12 recommendations. The study recommends that new national policy initiatives are needed to stimulate implementation of these best practices.

Considering healthcare organizations and practices that have not yet implemented EHR systems or fail to use all the in-built capabilities of their EHR, high cost involved and lack of in-house resources are the major concerns. The use of physician dictation and medical transcription with the support of EHR-integrated medical transcription services could be more economical, and ensure a more complete patient record.