The Institute of Medicine, under the charter of the National Academy of Sciences, considers electronic health records (EHR) key to improving health care, as medication and treatment errors and other adverse events would likely decrease significantly if EHR were in widespread use. EHR are particularly relevant to specialties that rely heavily on diagnostic images and technical data, such as ophthalmology. A recent study by the American Academy of Ophthalmology is the first to assess use of EHR by U.S. ophthalmologists (Eye M.D.s).
The study collected and analyzed the responses of 592 Academy member ophthalmologists who voluntarily completed a standardized survey online or in a telephone interview in March 2006; the full study group was 3,800 randomly selected members. The survey tracked ophthalmologists’ EHR use (implemented, in process, planned, not planned), importance or value to the user of a variety of EHR features, patient and practice demographics, and system details in practices using EHR.
Of the surveyed practices 12 percent had EHR systems in place, 7 percent were in the implementation process, and 10 percent had plans to do so within 12 months. Among practices with EHR: 69 percent were satisfied or extremely satisfied; 64 percent reported increased or stable productivity; 51 percent reported decreased or stable overall costs; and 76 percent would recommend the use of EHR to fellow ophthalmologists. EHR features rated as most valuable were similar among users and included improved patient care and billing/charge collection. The EHR adoption rate among ophthalmologists is similar to that of other U.S. medical specialties, which is 13 to 15 percent; in contrast, EHR implementation is nearly universal in Europe and the United Kingdom, the researchers noted.
Given these positive findings, why is EHR use still limited among U.S. ophthalmologists? Survey respondents cited high initial investments of money and physician time to select and implement an EHR system as the main barriers. Physicians realize that to be highly beneficial, EHR must be in nearly universal use. New government initiatives could hasten this: the House of Representatives Energy and Commerce Committee recently approved health information technology legislation that would provide incentives for physician adoption of EHR. In addition, the National Health Information Infrastructure initiative of the Department of Health and Human Services is working to build a distributed network of government EHR that would support retrospective research, prospective clinical trials, and early detection of epidemic or bioterrorism disease outbreaks.-American Academy of Ophthalmology
