Study: EHRs Provide Benefits, Challenges for Primary Care Practices

January 29, 2015 in News

While electronic health record systems have improved teamwork among clinicians at some primary care practices, system limitations also have created several challenges for care teams, according to a study published in the Journal of the American Medical Informatics Association, EHR Intelligence reports (Murphy, EHR Intelligence, 1/28).

For the study, researchers interviewed 63 staff members working in a wide range of roles at 27 primary care practices recognized as patient-centered medical homes by the National Committee for Quality Assurance (O’Malley et al., JAMIA, 1/27).

Findings on Benefits, Challenges

Respondents cited several benefits of EHR systems, including:

  • Assisting to redefine team roles;
  • Enabling non-physician team members take on larger roles in patient care;
  • Enabling physician team members to carry out more complex tasks;
  • Enhancing care coordination by providing better access to patient data, in-chart notes, instant messaging capabilities, telephone messages and task assignments; and
  • Improving communication and delegation of tasks.

In addition, respondents participating in the meaningful use program said that their EHR system’s capability to delegate EHR reporting activities helped their practice track needed information.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

However, respondents said EHR systems also had several design limitations that created challenges for care teams. Specifically, respondents said some EHR systems lack:

  • Management functionality or tools, which caused some practices to have some care team members use separate IT systems to track patients’ progress and document interactions with patients;
  • Registry functionality, with about 20% of practices lacking registry functionality and some choosing not to use the feature because of limited search capabilities; and
  • Standardized EHR data entry functionality and logging systems for data accountability, which are needed to comply with regulatory and organizational policies.


According to the researchers, many of the practices were able to come up with work-arounds to such challenges by:

  • Customizing their EHR systems to allow for team-wide collaboration; and
  • Working with third-party data warehouses or larger affiliated organizations to create EHR data reports.

The researchers wrote, “Respondents believed that EHR vendors need to work alongside practicing clinicians to help create clinically meaningful care plan functionalities within EHRs that can be updated over time, as patient preferences and needs change, and that can be accessed by all relevant team members, including the patient.”

They added that “clinical workflows need to evolve alongside EHR customization and development of new functionalities, where possible” and that practices will require “coaching and support to adapt clinical workflows to accomplish team-based tasks and to customize EHRs to match those workflows” (EHR Intelligence, 1/28).

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