EHR implementation first step toward quality improvement

(HealthDay)—Implementation of electronic health records (EHRs) is a first step toward quality improvement and should be accompanied by use of new payment models to allow physicians to see a return on their investments, according to Farzad Mostashari, M.D., of the Office of the National Coordinator for Health Information Technology, who was recently interviewed by the American Academy of Family Physicians.

Mostashari answered many of the questions family physicians have been posing to the Academy relating to the implementation of EHRs and also reviewed how the nation is doing in its quest to automate the health care system via widespread implementation of EHRs.

Mostashari notes that in order to maximize the productivity of EHRs, it is important to redesign the care flow to designate what can be done by people and what can be done via EHR technology. Many of the gains of EHRs are not reflected in revenue for physicians who operate in a fee-for-service environment. When value is added, it should be reflected in increased physician reimbursement, either through a patient-centered medical home setting, value-based purchasing, or as part of an accountable care structure. More than 80 percent of all studies on EHRs have demonstrated positive results, but implementation of EHRs is a first step toward the quality improvement. Stage two of meaningful use is about patient engagement and empowerment, which should be embraced as an opportunity to educate and involve patients. A recent survey from the National Center for Health Statistics suggested that 15 percent of office-based physicians were dissatisfied with their EHRs; this number may grow, and hopefully vendors will focus on user-centered design in the next iteration.

"Implementation is just the first step in gaining quality improvement," Mostashari said during the interview. "It's also important to learn from our failures and successes, identify the bright points and ask: 'Why did technology work in this instance?'"