Physicians Weigh In On Meaningful Use

Aug. 27, 2009

With so much speculation about the definition of “meaningful use,” Nuance asked more than 15,000 of its physician customers what the term means to them. “Not only did we seek to learn what physicians consider essential elements of the definition,” says Keith Belton, senior director of product marketing at Nuance, “we wanted to get their views on how, if at all, speech recognition plays a part in physicians achieving true meaningful use of electronic health records (EHR).” According to the survey:

Ninety-three percent disagree or strongly disagree that using an EHR has reduced time spent documenting care. EHRs are considered by most doctors to potentially “dumb down” the quality of patient documentation; 74 percent of the doctors surveyed said EHR cookie-cutter templates and patient notes with no uniqueness are challenges to realizing the full value of EHRs.

When asked about qualifications that the federal government should measure as part of pay-outs associated with EHR meaningful use, physicians cited the following: 90 percent said access to medical records faster without waiting for records to come out of transcription was important or very important; 83 percent said more complete patient reports, with higher levels or detail on the patient’s condition and visit were important or very important; 83 percent said better caregiver-to-caregiver communication based on improved reporting that is more accessible and easily shareable was important or very important; 79 percent said improved documentation by pairing the EHR point-and-click template with physician narrative was important or very important.

When asked about the importance of various EHR components, physicians identified the following as the five most important: lab test results reporting and review; tools that allow doctors to dictate a physician narrative into the EHR; e-prescribing; secure health messaging between caregivers; and keyboard support via speech recognition for data entry into the EHR.

In an era when the availability of transcription services has been sharply reduced to pay for many organizations’ EHR purchases, and physicians have only the keyboard and mouse to rely on, EHR adoption has proven a struggle, according to the survey. Sixty-seven percent of the doctors surveyed cited “time associated with reliance on keyboard and mouse to document within an EHR,” as a concern.

“If doctors rely solely on manual methods, they may not succeed in capturing all the necessary data within the EHR,” explains Belton, “which is a priority, given the fact that 93 percent of doctors surveyed either agree or strongly agree with the statement, “Capturing physician narrative as part of the documentation process is necessary for complete and quality patient notes.”

Productivity tools that help doctors to document better care within an EHR (beyond the keyboard and mouse) were cited by 75 percent of the doctors surveyed as an incentive to EHR adoption; whereas 69 percent cited “stimulus money,” showing the concern doctors have with not only getting the EHR system in the door, but effectively using it.

PACS Goes Vendor Neutral

Many hospitals are considering new vendor-neutral solutions for archiving and accessing medical images in order to avoid being locked into closed, proprietary software, according to a new report from KLAS that examines the enterprise imaging (EI) market. The study found that while many providers are looking to their picture archiving and communication system (PACS) vendor as a likely EI partner, they also recognize the potential pitfalls of getting locked into a proprietary solution that may not translate well from one department to another.

“Traditional PACS vendors like Philips, GE,
FUJIFILM were frequently mentioned by providers as likely candidates for an EI solution,” says Ben Brown, general manager of imaging informatics for KLAS and author of the report. “But those same providers were also adamant that they want to own their image data and not leave it hostage to the PACS vendor.

“A number of hospitals are beginning to take ownership of their medical images by building PACS-neutral archives and storage management layers,” Brown adds.

Administrative Cost-cutting Needed

The Council for Affordable Quality Healthcare (CAQH) reports that healthcare providers and health plans using the phase I rules of its Committee on Operating Rules for Information Exchange (CORE) showed dramatic cost savings, accelerated use of real-time electronic transactions, improved claims verifications and reduced claims denials. The estimated potential savings from an industrywide implementation of the CORE phase I rules are more than $3 billion in three years.

Conducted for CAQH by IBM’s Global Business Services, the study assessed six CORE-certified health plans that represent 33 million covered lives, as well as leading provider groups and vendors using the CORE phase I rules.

Key findings of the study: Electronic insurance eligibility verifications took approximately seven minutes less than telephone verifications, saving providers $2.10 per verification; and providers working with CORE-certified health plans saw 10 percent to 12 percent fewer claims denials, resulting in improved practice payment.

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