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  • Ophthalmologists’ Adoption and Perceptions of EHRs

    By Lynda Seminara
    Selected By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, February 2018

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    Lim et al. looked at rates of electronic health record (EHR) use among oph­thalmologists and gathered EHR-related financial and clinical opinions from these specialists. They found that, al­though EHR adoption has increased in recent years, ophthalmologists continue to express concerns about the systems.

    For their study, the authors used a population-based, cross-sectional, random sample of 2,000 ophthalmol­ogists. The sample was obtained from the Academy’s 2015 active member­ship database (U.S. members), and the research was conducted in 2015 and 2016. A survey was emailed to each ophthalmologist to inquire about adoption of the EHR, perceptions of fi­nancial and clinical productivity related to EHRs, and involvement in Medicare/Medicaid programs that offer incentives for EHR use.

    Among the 348 ophthalmologists who responded, 72.1% were currently using an EHR system. This rate is sub­stantially higher than in a 2011 survey (47% adoption rate) and is similar to that for primary care physicians (79% adoption rate). Most respondents believe that EHR use contributed to declines in productivity and net revenue and to higher practice-related costs. Of the respondents who attested to stage 1 of the EHR meaningful use incentive pro­gram, 83% planned to attest to stage 2.

    Most respondents are of the opinion that EHR use has not affected the abil­ity to capture charges for office visits, procedures, and tests. One-fourth of the surveyed specialists believe the EHR system has improved their ability to provide quality care, but 35% suspect that paper records are more conducive to delivering quality care. Most respon­dents noted that patients’ attitudes toward the EHR are either positive or neutral. Subanalyses of data by the number of years in practice showed no statistically significant differences between junior and senior ophthalmol­ogists.

    These results suggest that the EHR system needs modification to optimizeits value for ophthalmologists. Ideally, the utility of the record itself should be improved, and the government’s requirements for using it meaningfully should be clarified and incorporated. (Also see related commentary by Jennifer S. Weizer, MD, Joshua R. Ehrlich, MD, MPH, and Paul P. Lee, MD, JD, in the same issue.)

    The original article can be found here.