Watertown, Mass.-based Athenahealth surveyed 1,200 users of its Epocrates electronic decision-support and clinical workflow products in March 2013. Among respondents, 47% were in independent practice, 70% were specialists and 30% were primary-care doctors.
Only 9% expressed optimism about the future viability of independent practice. Similarly, only 17% saw the “quality of medicine” improving in five years; 24% expected it to remain unchanged; and 59% expected quality to decline.
Seventy-six percent of respondents said they work at a practice using an EHR, but only 52% said they had an active role in the purchase of the system. Despite this, they still have a positive opinion about EHRs. This includes 31% with a very favorable opinion; 38% with a somewhat favorable opinion; 14% are neutral; 12%, somewhat unfavorable; and 6%, very unfavorable. Respondents were split on the cost benefits of EHRs, with 51% saying the financial benefits don't outweigh the costs and 55% saying the patient-care benefits outweigh the costs.
In regard to payers, 41% of respondents strongly agreed with the statement that insurers' payment processes had become increasingly burdensome and complex, with 38% agreeing and 18% neither agreeing nor disagreeing. For Medicare, 33% strongly agreed its payment process was becoming increasingly burdensome and complex; 32% agreed; and 31% were neutral. For Medicaid, 35% strongly agreed, 30% agreed, and 31% were neutral.
While only a minority of respondents agreed that government involvement can lower costs and improve outcomes, this year more were in the pro-government camp than were in it last year. Of those surveyed in 2013, 6% strongly agreed that government involvement could lower costs; 32% agreed; 18% were neutral or undecided; 24% disagreed; and 31% strongly disagreed. Last year, only 5% said they agreed that government could lower costs; 20% agreed; 14% neither agreed nor disagreed; 27% disagreed; and 35% strongly disagreed.
This year, 5% strongly agreed that government involvement could improve outcomes; 29% agreed; 24% were neutral or undecided; 28% disagreed; and 25% strongly disagreed. In comparison, in 2012, only 4% strongly agreed that government involvement could improve outcomes; 16% agreed; 19% neither agreed nor disagreed; 29% disagreed; and 32% strongly disagreed.
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