Adoption of electronic health records and perceptions of financial and clinical outcomes among ophthalmologists in the United States

Michele C. Lim; Michael V. Boland; Colin A. McCannel; Arvind Saini; Michael F. Chiang; K. David Epley; Flora Lum

doi:10.1001/jamaophthalmol.2017.5978

Adoption of electronic health records and perceptions of financial and clinical outcomes among ophthalmologists in the United States

Michele C. Lim, Michael V. Boland, Colin A. McCannel, Arvind Saini, Michael F. Chiang, K. David Epley, Flora Lum

School of Medicine

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Importance: Assessing the rate of electronic health record (EHR) adoption and ophthalmologists' perceptions on financial and clinical productivity is important in understanding how to direct future design and health care policy. Objective: To assess adoption rate and perceptions of financial and clinical outcomes of EHRs among ophthalmologists in the United States. Design, Setting, and Participants: Population-based, cross-sectional study. A random sample of 2000 ophthalmologists was generated on the basis of mailing address zip codes from the 2015 American Academy of Ophthalmology US active membership database, which included more than 18 000 ophthalmologists. A survey was sent by email to assess adoption rate of EHRs, perceptions of financial and clinical productivity, and engagement with Medicare and Medicaid programs that incentivize the use of EHRs. The survey was conducted between 2015 and 2016. Main Outcomes and Measures: Adoption rate of EHRs and perceptions of financial and clinical productivity. Results: The adoption rate of EHRs among surveyed ophthalmologists (348 respondents) was 72.1%. The responding ophthalmologists perceived that their net revenues and productivity have declined and that practice costs are higher with EHR use. Of those who attested for stage 1 of the EHR incentive program, 83%had already or were planning to attest to stage 2, but 9% had no plans. Conclusions and Relevance: The adoption of EHRs by ophthalmologists has more than doubled since a 2011 survey and is similar to that of primary care physicians (79%). In comparison with 2 previous surveys of ophthalmologists, respondents had more negative perceptions of EHR productivity outcomes and effect on practice costs, although financial data were not collected in this survey to support these opinions. These negative perceptions suggest that more attention should be placed on improving the efficiency and usability of EHR systems.

Original language	English (US)
Pages (from-to)	164-170
Number of pages	7
Journal	JAMA ophthalmology
Volume	136
Issue number	2
DOIs	https://doi.org/10.1001/jamaophthalmol.2017.5978
State	Published - Feb 2018

ASJC Scopus subject areas

Ophthalmology

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10.1001/jamaophthalmol.2017.5978

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title = "Adoption of electronic health records and perceptions of financial and clinical outcomes among ophthalmologists in the United States",

abstract = "Importance: Assessing the rate of electronic health record (EHR) adoption and ophthalmologists' perceptions on financial and clinical productivity is important in understanding how to direct future design and health care policy. Objective: To assess adoption rate and perceptions of financial and clinical outcomes of EHRs among ophthalmologists in the United States. Design, Setting, and Participants: Population-based, cross-sectional study. A random sample of 2000 ophthalmologists was generated on the basis of mailing address zip codes from the 2015 American Academy of Ophthalmology US active membership database, which included more than 18 000 ophthalmologists. A survey was sent by email to assess adoption rate of EHRs, perceptions of financial and clinical productivity, and engagement with Medicare and Medicaid programs that incentivize the use of EHRs. The survey was conducted between 2015 and 2016. Main Outcomes and Measures: Adoption rate of EHRs and perceptions of financial and clinical productivity. Results: The adoption rate of EHRs among surveyed ophthalmologists (348 respondents) was 72.1%. The responding ophthalmologists perceived that their net revenues and productivity have declined and that practice costs are higher with EHR use. Of those who attested for stage 1 of the EHR incentive program, 83%had already or were planning to attest to stage 2, but 9% had no plans. Conclusions and Relevance: The adoption of EHRs by ophthalmologists has more than doubled since a 2011 survey and is similar to that of primary care physicians (79%). In comparison with 2 previous surveys of ophthalmologists, respondents had more negative perceptions of EHR productivity outcomes and effect on practice costs, although financial data were not collected in this survey to support these opinions. These negative perceptions suggest that more attention should be placed on improving the efficiency and usability of EHR systems.",

author = "Lim, {Michele C.} and Boland, {Michael V.} and McCannel, {Colin A.} and Arvind Saini and Chiang, {Michael F.} and Epley, {K. David} and Flora Lum",

note = "Funding Information: completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Chiang reports grants from the National Institutes of Health (EY19474, EY22387, and EY10572), National Science Foundation (1622679), and Research to Prevent Blindness. He is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems and Consultant on the Steering Committee member for RAINBOW study at Novartis. Dr Boland reports research support from Alcon Labs. No other disclosures were reported. Funding Information: This project was supported by funding from the American Academy of Ophthalmology, San Francisco, California. Publisher Copyright: {\textcopyright} 2018 American Medical Association. All rights reserved.",

year = "2018",

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doi = "10.1001/jamaophthalmol.2017.5978",

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AU - Boland, Michael V.

AU - McCannel, Colin A.

AU - Saini, Arvind

AU - Chiang, Michael F.

AU - Epley, K. David

AU - Lum, Flora

N1 - Funding Information: completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Chiang reports grants from the National Institutes of Health (EY19474, EY22387, and EY10572), National Science Foundation (1622679), and Research to Prevent Blindness. He is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems and Consultant on the Steering Committee member for RAINBOW study at Novartis. Dr Boland reports research support from Alcon Labs. No other disclosures were reported. Funding Information: This project was supported by funding from the American Academy of Ophthalmology, San Francisco, California. Publisher Copyright: © 2018 American Medical Association. All rights reserved.

PY - 2018/2

Y1 - 2018/2

N2 - Importance: Assessing the rate of electronic health record (EHR) adoption and ophthalmologists' perceptions on financial and clinical productivity is important in understanding how to direct future design and health care policy. Objective: To assess adoption rate and perceptions of financial and clinical outcomes of EHRs among ophthalmologists in the United States. Design, Setting, and Participants: Population-based, cross-sectional study. A random sample of 2000 ophthalmologists was generated on the basis of mailing address zip codes from the 2015 American Academy of Ophthalmology US active membership database, which included more than 18 000 ophthalmologists. A survey was sent by email to assess adoption rate of EHRs, perceptions of financial and clinical productivity, and engagement with Medicare and Medicaid programs that incentivize the use of EHRs. The survey was conducted between 2015 and 2016. Main Outcomes and Measures: Adoption rate of EHRs and perceptions of financial and clinical productivity. Results: The adoption rate of EHRs among surveyed ophthalmologists (348 respondents) was 72.1%. The responding ophthalmologists perceived that their net revenues and productivity have declined and that practice costs are higher with EHR use. Of those who attested for stage 1 of the EHR incentive program, 83%had already or were planning to attest to stage 2, but 9% had no plans. Conclusions and Relevance: The adoption of EHRs by ophthalmologists has more than doubled since a 2011 survey and is similar to that of primary care physicians (79%). In comparison with 2 previous surveys of ophthalmologists, respondents had more negative perceptions of EHR productivity outcomes and effect on practice costs, although financial data were not collected in this survey to support these opinions. These negative perceptions suggest that more attention should be placed on improving the efficiency and usability of EHR systems.

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Adoption of electronic health records and perceptions of financial and clinical outcomes among ophthalmologists in the United States

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