A survey of members of the Association of American Physicians and Surgeons found that the threat of government mandates may pose the biggest barrier to adoption of electronic health-record systems, followed in close order by costs and privacy concerns.
The survey of 430 members released last month reported that 19% of respondents used an EHR. Of those 81% of survey respondents who did not, 78% listed concern about government mandates for implementation as a barrier to adoption, followed by 77% with a concern about link to centralized government medical records as a close second. Lack of capital for initial cost and training ranked third as a barrier, selected by 75% of respondents; concern about privacy protection came in fourth at 74%.
Asked what incentives would have an impact on their decision to implement an EHR, members of the Tucson, Ariz.-based AASP listed a guarantee that systems would not be linked to P4P (pay-for-performance) or EBM (evidence-based medicine) mandates most often at 60%; followed by enhanced legal protections for EHR users at 55%; monetary incentives for purchase, 54%; and training, 52%.
The 14-page report contains more than 11 pages of comments from physicians across 18 medical specialties, both those who use EHRs and those who do not, some not for the lack of trying. One participant noted his group had sunk more than $200,000 into an EHR system and needed hardware and have never been able to make it function over the past (five) years.
According to one comment listed, regardless of incentive, I still wouldnt do it because privacy cannot be protected. Another said, At tremendous cost we have enjoyed the small benefits with decreased transcription and filing cost and faster access to records.
But not all respondents suggested theyd made a mistake buying an EHR. At this practice, one commenter wrote, we made the decision from the beginning to use an EHR. It has not been as good as we hoped and still too expensive for upgrades, but I would not want paper records again. -- by Joseph Conn