Study Shows 96 Percent of Doctors Concerned with Transition to EHRs

Dec. 23, 2009

BURLINGTON, Mass., December 21, 2009Nuance Communications, Inc. (NASDAQ: NUAN), has clinical documentation and communication solutions in more than 5,000 healthcare organizations, and more than 250,000 physician users across the United States.  Nuance recently engaged more than 17,000 physicians in a survey to learn about physicians’ hopes and concerns with respect to healthcare information technology, as well as to gauge their understanding of developing healthcare government policy. Today, Nuance is announcing results from its survey, which represent responses from nearly 1,000 physicians.

Over the last several months, the Centers for Medicare and Medicaid Services have been working closely with the Office of the National Coordinator for Health IT (ONCHIT) and the Department of Healthcare and Human Services (HHS) to define the incentive programs outlined in the HITECH Act.  HHS is expected to publicly release a draft definition of electronic health record (EHR) “meaningful use” by the end of December 2009.

As the HIT Policy Committee works to finalize the “meaningful use” definition, Nuance’s survey found that there is concern that too much emphasis will be put on data capture and quantitative measures alone vs. the capture of qualitative information that helps tell each patient’s unique health story. There is also concern over the long-term impact of the HITECH initiative.

  • When physician respondents were asked how concerned they are “about losing the unique patient story with the transition to point-and-click (template-driven) EHRs,” 96 percent voiced concern, reinforcing the need for patient health records to be created using a combination of structured and narrative information.
  • 94 percent said that “including the physician narrative as part of patients’ medical records” is “important” or “very important” to realizing and measuring improved patient outcomes.
  • Less than 10 percent of physician respondents said they were either “confident” or “very confident” that “the federal government’s health information technology and reimbursement standards will lead to higher quality patient health records.”

“I am a clinician first and last. I believe in the sanctity of the physician-patient relationship and that without the focus and the belief that care must be patient centered, the quality of care will always be suboptimal,” said Stephen M. Sergay, MB BCh, Immediate Past President, American Academy of Neurology. “Humanism needs to be restored to the overwhelming demands of technology, scientific advances and econometrics. I believe that delivery of high quality care begins with the physician-patient encounter, therefore demanding a quality narrative of the history of the main complaint.”

“It has become increasingly clear that capturing what the physician is thinking at the point-of-treatment contributes significantly to ongoing, high quality patient care and outcomes. Without an established regulation to require the inclusion of such detailed physician notes in addition to structured data, there is concern amongst caregivers that patients’ medical records will be reduced to cookie-cutter documents that do not differentiate from one patient to the next,” said Peter Durlach, senior vice president, healthcare marketing and product strategy, Nuance Communications, Inc. “The clear guidance from the physician community is that the Department of HHS should consider a requirement to ensure that each electronic patient note is not limited to templated text and structured data elements alone.”

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