Thinking of buying an EHR system? A few things you need to know

with editorial assistance from Kristen Georgi

Are you considering the purchase of an electronic health record (EHR) system for your group practice? You are not alone. Clinicians across the country who are adopting these systems are talking about their benefits, drawbacks, and the overall level of success they are having in making the transition (see the Hellman and Persell/Bufalino articles in the June 2008 issue of Current Clinical Practice).

Before making this purchase, there are a number of things to consider. A variety of resources are presented below to assist you in making your selection. But first, a little background about the factors that have brought you to this juncture and led you to consider adopting this new technology.

  Arriving at the point of connection

A little more than 4 years ago, in April 2006, President George Bush announced his new technology agenda. He proposed, among other things, that physicians adopt new methods of information technology, migrating away from paper medical records toward the use of EHR systems. The intention is lofty: to “help transform health care in America—improving health care quality, reducing health care costs, preventing medical errors, improving administrative efficiencies, reducing paperwork, and increasing access to affordable health care” (http://www.whitehouse.gov/infocus/technology/). It was projected that with the implementation of this agenda, the majority of Americans would have EHR systems within 10 years.

To examine the utility of EHRs, the British Medical Journal published the results of a retrospective, cross-sectional study of more than 800,000 members of Kaiser Permanente in Colorado and the US Northwest in 2005. The report demonstrated that the benefits of EHRs in ambulatory care could be varied and substantial. Two years after EHRs were implemented in these practices, the number of age-adjusted office visits in both geographic areas was reduced by 9%, while allowing physicians to maintain contact with patients via telephone (http://bmj.bmjjournals.com/cgi/content/full/330/7491/581).

However, a survey published online in Health Affairs in 2006 found that only 23.9% of physicians used EHRs and only 5% of hospitals had the capability of providing online physician order entry. (http://content.healthaffairs.org/cgi/content/abstract/hlthaff.25.w496v1)

  Barriers and bridges

Health care professionals are under pressure to select an implement an EHR system into their practice according to an article by Richard Hellman, MD, in the June 2008 issue of Current Clinical Practice, and there have been varied responses from clinicians who have implemented them. Some of the obstacles these practices have encountered include getting up to speed with the technology and understanding what different systems offer, the need to change workflow habits to accommodate the new technology, and cost. Benefits include greater patient safety, improved communication and performance, and the ability to access patient records remotely. A report by the Medical Records Institute cites EHR system barriers and benefits as reported in a survey conducted in 2007.

  Forging ahead

If the time has come for you to consider purchasing an EHR system, here are links to a few resources that will help you to consider your needs and make the best selection for your practice:

• Groups push physicians and patients to embrace electronic health records http://jama.ama-assn.org/cgi/content/extract/299/5/507
• Personal health records and personal health record systems: National Committee on Vital and Health Statistics www.ncvhs.hhs.gov/0602nhiirpt.pdf
• 2007 Physician’s guide to certification for ambulatory health records www.cchit.org/files/CCHITPhysiciansGuide 2007.pdf