asks the vendor to rectify the problems. The vendor responded by notifying the practice it would send a program man- ager to assess the problems with the sys- tem and develop a plan for fixing them. One of the physicians in the practice says he hopes problems with the vendor can be resolved because switching to an- other company would require even more time and money.
EHR satisfaction among users in small medical groups is declining. (See “Undesired Consequences,” page 36.) AmericanEHR Partners and the Ameri- can College of Physicians developed multiple surveys from March 2010 to December 2012 and analyzed 4,279 cli- nician responses. (See “Clinician Satis- faction With EHRs,” at right.) Dr. Fleeger acknowledges that initial adoption of an EHR is bound to have its challenges, but says some groundwork at the start of the process helps ensure a successful transition. Before selecting an EHR, Dr. Fleeger and his partners determined how they would access their health information technology (HIT) software. Physicians can choose one of two models: client server or application service provider (ASP). The client-server model features HIT software installed on a server in the physician’s office, accessible through the practice’s input devices. The ASP model houses software on a remote server, ac- cessible most commonly via the Internet. TMA’s Electronic Medical Record Im- plementation Guide: The Link to a Bet- ter Future has more information on the advantages and disadvantages of each model. To access the publication, visit
www.texmed.org/learn, and click on the Technology link. “For us, the most logical model was ASP because it allows us to use our EHR at any of our four office locations and to access information with any mobile device at any hospital we work with 24 hours a day,” Dr. Fleeger said. After narrowing down their vendor choices, the group evaluated the top contenders’ performance in other medi- cal practices. The Electronic Medical Re- cord Implementation Guide features these two general guidelines for site visits:
Clinician satisfaction with EHRs
EHR satisfaction and usability ratings from 2010 to 2012
Users who are “very dissatisfied” from 2010 to 2012
Clinician respondents in practices of 10 or fewer physicians
-12% +10% 71% 65% 82%
Intended participation in meaningful use incentive programs 2010 2012 Would not recommend their EHR to a colleague 24% 39% 2010 2012 “Very dissatisfied” with EHR’s ability to decrease workload 19% 2010 Dissatisfaction with ease of use 23% 2010 Satisfaction with ease of use 61% 48% 2010 2012 Source: AmericanEHR Partners and the American College of Physicians July 2013 TEXAS MEDICINE 33 37% 2012 34% 2012
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