Care coordination barely improved by docs’ use of EHR, health IT

If harmonizing the work of two or more doctors treating the same patient is a key reason for computerizing healthcare, then health information technology is singing somewhat off key.

That’s one way to sum up a new study whose authors looked at EHR usage and electronic information sharing by more than 4,500 U.S. physicians who participated in the 2012 National Electronic Health Records Survey. The study is running in the February issue of Medical Care, a journal of the American Public Health Association published by Wolters Kluwer Health.

The study report states that, among responding physicians routinely receiving information needed for care coordination, at least 54 percent did not receive the information electronically.

“Although a higher percentage of physicians using health information technology (HIT) received patient information necessary for care coordination than those who did not use HIT, more than one third did not routinely receive the needed patient information at all,” write the authors, who were led by Chun-Ju Hsiao, PhD, MHS, of the U.S. Agency for Healthcare Research and Quality in Rockville, Md.

Fewer than half of the physicians using HIT, 48 percent, reported that they routinely received information on patients being simultaneously treated by other practices. That wasn’t much better than the 40.4 percent who only get that information by fax or an even older-fashioned way.

The authors point out that care coordination has been shown to provide better care at lower cost. Meanwhile, they note, lack of coordination and communication across healthcare settings opens the door to all sorts of serious complications, from medication errors to preventable hospital readmissions.

The study follows previous analyses showing that many doctors don’t receive the information they need to provide coordinated care, electronically or otherwise.

The authors offer little in the way of commentary on the scenario of a wired healthcare world missing an obvious opportunity for improvement, although a subtle sense of exasperation can be suspected if not detected.

“Even among physicians with EHRs and the capability to share information electronically, 14.4 percent and 13.4 percent did not receive patient history and the reason for a referred consultation,” the authors write, stressing that the majority of doctors who routinely receive such information get it non-electronically.

“These results suggest that EHR adoption and the capability for electronic sharing of patient health information among office-based physicians alone may not be enough to ensure the regular sharing of key information for care coordination,” they write. “Our findings inform our understanding of continuing challenges to using HIT to coordinate care between providers.”

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