Physicians View EMRs as “Still Too Clunky”

The number of physicians using health care information technology in their practices has increased dramatically in the past 5 years, as have their frustrations with the available software. Results of the second Health Care Technology Survey conducted by the American College of Physician Executives (ACPE) found that 64.5% of physicians use electronic medical records (EMRs), up from 33.1% in 2004. The 2009 survey was open from November 15 to December 20, and 950 ACPE members participated.

The number of physicians who prescribe electronically more than doubled, from 20.9% in 2004 to 42.2% in 2009. The use of computerized physician order entries jumped from 23.3% to 43.8% during the period. More than one-third (38.4%) of respondents reported using pharmaceutical bar coding, up from 20.1% in 2004. About one-fifth (19.7%) of physicians communicate with patients via e-mail, which is a slight increase over the 2004 rate (18.2%). The clinical use of personal digital assistants fell from 36.2% in 2004 to 33.7% in 2009.

When asked why they use health care information technology, about one-third (32.9%) of respondents said it reduces liability and medical errors, 28.1% said it led to more accurate recordkeeping, and 21.2% said they were trying to keep current.

Complaints about the technology were similar to those voiced 5 years ago. About 41% of physicians cited a lack of money or resources as the major obstacle they faced when implementing the technology. Nearly one-fifth (19.6%) reported a lack of support or buy-in from physicians and other medical staff, and 11.9% said it was too difficult to integrate new technology with other computer systems already in use. Most physicians said EMR systems are “still too clunky, too hard to use, and too poorly developed” to be helpful. ?

DTC Drug Ads: How Effective?
Direct-to-consumer (DTC) advertising of prescription drugs appears to have less effect on physician-patient encounters in 2008 than in 2003. Bennett Parnes, MD, associate professor, department of family medicine at the University of Colorado School of Medicine (UCSM), Aurora, and colleagues reported that a patient asked about a specific new prescription medication in only 3.5% of encounters, down from 15.8% in a 2003 study. When the analysis was limited to prescription drugs advertised in recent years, the rate dropped to 2.6%. Findings of the study, which was funded by the UCSM, were published in the January/February issue of the Annals of Family Medicine.

The researchers conducted a cross-sectional survey of 168 clinicians who completed a form after each of the 1647 physician-patient encounters included in the study. The physicians recorded any inquiries about specific prescription drugs and reported that the patients had heard about the medications through DTC advertising 20.7% of the time, and from family or friends 32.8% of the time.

The lower inquiry rate in the current study might be explained by the high number of low-income patients, who might avoid asking for advertised prescription drugs because of concern about high cost, and the large proportion (43.6%) of Hispanic patients included in the study, many of whom speak only Spanish and therefore have decreased exposure to such advertising, the researchers said. However, they noted that the findings might also reflect the declining influence of DTC advertising, which exposes the average American to 100 minutes of televised DTC advertising of prescription drugs for each minute of time spent with a physician. ?