The use of touch-screen computers to input clinical information is on the rise while budget constraints appear to be easing as a barrier to adoption of electronic health records, according to a survey of information technology usage by the Medical Records Institute, Boston.
The use of touch screens rose from 23.9% in 2002 to 30.2% in 2004, something of a surprise, according to Jeff Blair, vice president of the institute.
"I think that's because more EHRs are going into ambulatory settings where they're more likely to have touch screens," he said.
Money is still the number one barrier to EHR adoption, as it has been for all six years of the survey, but times may be changing, according to Blair. The percentage of respondents who listed money as a major barrier dipped to 55.5% this year, down from 64.2% last year and 58.5% in 2002.
"That means funding for EHRs is getting into the budgets," Blair said. Meanwhile, he said, "The types of impediments that reflect implementing (problems) were equal to or greater than before.
"The industry has moved forward," he said. "Now the barriers are getting down to the selection, purchasing and implementation of EHRs."
The survey of 436 providers was conducted between April 30 and June 11.
Institute officials concede the survey is not strictly scientific, in that survey respondents were recruited to take the survey online by e-mail solicitations. This is the sixth year the MRI has conducted the survey, however, which gives it strength in continuity of certain questions over time.
Further, typical survey respondents "are clearly knowledgeable about healthcare IT solutions and plans," according to the for-profit institute that sponsors the 20-year-old Towards and Electronic Patient Record, or TEPR, trade show, which touts healthcare information technology.
"This survey has done a very good job over the years of identifying trends," said Blair, who heads the survey team.
For example, Blair notes that in the 2004 survey, keyboards remain the most common electronic medical-record input device (used by 83.7% of providers surveyed), followed by dictation without using speech recognition software (68.6%) and with speech recognition software (31.7%), and by scanners (59.7%). Percentages for all four input methods have remained largely unchanged since 2002, which makes the shift in touch-screen computer usage stand out, Blair said.
Another notable shift is the heightened interest in the survey itself by providers of ambulatory care. This year, 44.5% of respondents said they spent most of their workday in ambulatory care, compared with 26.3% two years ago. Hospital-based respondents correspondingly declined from 51.4% to 31.4% of those who took the survey.
Of 199 respondents who said they worked in ambulatory care and have an EHR, 21.6% said their system stands alone and is not integrated into or interfaced with a practice management system.
Other key changes, according to Blair, include heightened interest in e-prescribing technologies and the emphasis on workflow improvement as a reason driving EHR adoption.
"These last two years, improving workflow was listed at the top, where, for all the years previous to that, the top was the need to share data," Blair said. "I think that reflects a maturation in the market, that clinicians understand that the EMRs do more than just capture and retrieve information, that they are an enabler to improve clinical performance and office workflow."