Monday, June 15, 2009

Electronic Health Records (EHR) & “Meaningful Use” survey results & Speech Recognition Technology

Electronic health records (EHR) have been recognized as a core component to national healthcare reform in the United States. Beginning in 2011, physicians and hospitals can receive bonus payments under Medicare and Medicaid, but only if they are found to be “meaningful EHR users.” Nuance Communications, Inc., a leading supplier of speech solutions that are expected to help with the transition to and utilization of EHR, surveyed physicians to better understand how “meaningful use” should, from their point of view, ultimately be defined.

A couple of my prior posts were about speech recognition and another couple of my prior posts were about electronic health records. So, I was interested in the results of this survey.

The EHR Meaningful Use Physician Study shows —

93 percent of doctors “disagree” or “strongly disagree” that using an EHR has reduced time spent documenting care.

When asked what doctors consider an “incentive to drive national EHR adoption,” 75 percent of the physicians surveyed said they consider “access to tools that would help doctors to better document within an EHR (beyond the keyboard), such as speech recognition” an incentive; whereas 69 percent cited “stimulus money.”

When asked about qualifications that the federal government should measure as part of pay-outs associated with EHR meaningful use, physicians cited the following:

  • 90 percent said “access to medical records faster without waiting for records to come out of transcription,” was “important” or “very important.”
  • 83 percent said “more complete patient reports, with higher levels or detail on the patient’s condition and visit,” was “important” or “very important.”
  • 83 percent said “better caregiver-to-caregiver communication based on improved reporting that is more accessible and easily shareable,” was “important” or “very important.”
  • 79 percent said, “improved documentation by pairing the EHR point-and-click template with physician narrative,” was “important” or “very important.”

When asked about the importance of various EHR components, physicians identified the following as the five most important:

    • Lab test results reporting and review
    • Documentation tools that allow doctors to speak the physician narrative into the EHR
    • E-Prescribing
    • Secure health messaging between caregivers
    • Keyboard support via speech recognition for data entry into the EHR

    74 percent of the doctors surveyed said “EHR cookie cutter templates” and “patient notes with no uniqueness” are challenges to realizing the full value of EHRs.

    93 percent of doctors surveyed either “agree” or “strongly agree” with the following statement, “I think capturing physician narrative as part of the documentation process is necessary for complete and quality patient notes.”

    67 percent of the doctors surveyed cited “time associated with reliance on keyboard and mouse to document within an EHR” as a major hurdle.

    My thoughts, after perusing these findings: On the one hand, this is a self-serving report created by a vendor of speech recognition products; On the other hand, this report suggests that there could be a good deal of resistance to EHR by physicians and hospitals if speech recognition technology is not successfully integrated into the coming EHR system(s). Stay tuned.