HIMSS Healthcare I.T. News
2010-1-8
 
Doctors concerned about getting accurate patient stories
By Jeff Rowe, Editor

For the foreseeable future, the debate over the usefulness of the recently released proposed “meaningful use” guidelines is likely to attract the lion’s share of attention from healthcare stakeholders and observers alike.

But the results of a recent survey of physicians are a timely reminder that policymakers have much more to grapple with moving forward than the details of the HITECH incentive program.

The survey was conducted by Nuance Communications, which provides speech and imaging products for businesses and consumers, and it was designed to help Nuance “learn about physicians’ hopes and concerns with respect to healthcare information technology, as well as to gauge their understanding of developing healthcare government policy.”

According to the survey summary, nearly 1,000 physicians responded, and the responses indicate deep concern about some of the potential impacts of EHR technology. In particular, many doctors are skeptical about the ability of new technologies to provide them with the patient “narratives” which factor significantly into their diagnoses.

As the summary explained, “when physician respondents were asked how concerned they are ‘about losing the unique patient story with the transition to point-and-click (template-driven) EHRs,’ 96 percent voiced concern, reinforcing the need for patient health records to be created using a combination of structured and narrative information.”

Moreover, “94 percent said that ‘including the physician narrative as part of patients’ medical records’ is ‘important’ or ‘very important’ to realizing and measuring improved patient outcomes.”

And, finally, “less than 10 percent . . .said they were either ‘confident’ or ‘very confident’ that ‘the federal government’s health information technology and reimbursement standards will lead to higher quality patient health records.’”

Part of the survey included asking doctors to review and respond to two versions of a patient’s note. “The first note was created by a doctor via speech recognition describing the patient encounter and care plan in narrative form (through the use of speech recognition technology). The second note (on the same patient, for the same visit) was created using an E HR point-and-click template, based on the structured elements selected by the doctor.”

The two resulting versions are included in the summary, and the differences are striking. Moreover, the differences were overwhelmingly noted by the survey’s respondents. Indeed, 97 percent of the doctors surveyed preferred the first version, using the “old” technology, over the version that used the newer EHR template.

Like all technology, health IT is going to keep evolving, and many of the concerns voiced by the doctors who responded to this survey are bound to be addressed. But policymakers who are pushing providers forward need to recognize that technology is valuable only in so far as it improves the delivery and cost of healthcare services.

And when it comes to the doctor-patient relationship, a big part of the delivery is getting the patient’s story right.