Three-fourths of U.S. physicians who use electronic health records (EHRs) said they aren’t cost-effective and don’t save time, but the majority said they still believe they have value in terms of providing data, a recent survey found.

The consulting firm Deloitte surveyed 561 physicians online and found that while 75% using EHRs believed that they actually increase costs, 70% said they “provide useful analytics” and 60% believed EHRs “support value-based care,” according to the survey.

In addition, nine out of 10 doctors were interested in mobile health applications, and of the 24% of physicians who were already active mobile health users, about half use mobile health applications daily, the survey found.

The 10% of physicians who weren’t interested in mobile health applications tended to be older, to be in solo or independent practice, and to have been in practice the longest, according to the survey.

As far as the benefits of mobile health were concerned, 75% of experienced mobile health users listed “accessing clinical information during patient encounters” as a benefit, as did 59% of nonusers. A total of 72% of experienced users said “researching specific diseases, conditions, interventions, and prescription medications” was another benefit, compared with 54% of nonusers, while “engaging in continuing medical education and staying current in healthcare” was seen as a benefit by 63% of experienced users and 48% of nonusers.

The survey also asked physicians how far along they were in terms of complying with “meaningful use” objectives for EHRs. A total of 56% said they were at Stage 2 of meaningful use; of those, 71% planned to go on to Stage 3. Another 26% of respondents were at Stage 1, while 18% said they had not started on meaningful use requirements yet.

Most physicians (68%) didn’t think meaningful use increased productivity, and 58% said it hasn’t distinguished their practice from other practices as far as patients are concerned. In addition, 48% said meaningful use “does not support care coordination.”

The survey identified security and privacy as important concerns among all physicians, whether or not they used EHRs. For example, 43% of respondents said “security and privacy of protected health information” was a constraint of mobile health, including 50% of mobile health users and 41% of nonusers.

On the other hand, only 38% of physicians felt that being able to monitor patients’ conditions and their treatment adherence was a benefit of mobile health, compared with 60% of consumers who were interested in using the technology for doing so.

Mitch Morris, MD, national leader for Deloitte’s health care provider sector, said in a phone interview that he was a “little disappointed that three out of four physicians surveyed thought that ‘This costs us extra and doesn’t save us any time.’”

Paired with a recent letter published in JAMA Internal Medicine finding that EHRs take an average of 48 more minutes per day of physicians’ time, the results show that “we have some work to do as an industry to get past this,” said Morris, of Austin, Texas. He noted that while physicians may see in theory the benefits of EHRs in terms of population health and coordination of care, they’re not seeing benefits personally in their own practices.

“The take-home message is that we still have work to do to optimize EHR implementation,” Morris told MedPage Today. “People were under the gun with meaningful use … Many drove hard to get things in by the deadline but didn’t think hard about how to leverage the technology to improve workflow, improve safety and quality, and have a positive impact on clinicians as well as on patients.”

Morris also highlighted the finding that only about a quarter of physicians regularly use mobile health apps. “You can’t say they’re technophobic; we’re still trying to figure out how mobile apps are going to deliver value,” he said. “I think we’re going to continue to see mobile health grow as mobile technologies increase their capacity [and offer] faster processing and greater connectivity, but [there are] still concerns about privacy and security with those apps.

“One has to wonder what is the disruptive technology that’s going to emerge in healthcare, similar to the way … Uber was disruptive to taxi business,” he said. “Truly elegant things you don’t have to implement much.”

For example, a lot of people buy products online because there’s a lot of value for them in doing so, said Morris. “We have to have the same value proposition… in mobile health so that it becomes a no-brainer that you are going to use it.”

For the survey, Deloitte used a random sample of U.S. primary care and specialist physicians selected from the American Medical Association’s master file of physicians. The survey data were collected June 2 to 23, 2014. Data were weighted to reflect national distribution by years in practice, gender, region, and medical specialty. The survey’s margin of error is plus or minus 3.89%.


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