through the Medicare and Medicaid programs that
adopted and showed meaningful use of certified EHRs. 4
The 2015 ACS Governors Survey asked a series of
questions about the use of EHR in both the office and
the hospital setting. Of the respondents, 78 percent
reported using an office EHR, and 89 percent said they
use a hospital EHR (see Figures 1 and 2, this page).
Despite the federal incentives for implementing
an office EHR system and Medicare reimbursement
penalties that took effect in 2015 for EPs who did not
participate in the Medicare EHR Incentive Program,
22 percent of the Governors reported that they do not
use an office EHR system.
Governors were asked how confident they were
that the information in their office and hospital EHR
system was current, complete, and accurate. For the
office EHR, 70 percent of the respondents were either
adequately confident ( 27 percent) or somewhat confident ( 43 percent) in the quality of data from their office
EHR. The remaining 30 percent were either not confident at all about the quality of data ( 25 percent), or felt
that the data were rarely complete, accurate, or even
available ( 5 percent) (see Figure 3, page 31).
Likewise, when asked about the hospital EHR,
70 percent of the respondents stated that they were
either adequately confident ( 29 percent) or somewhat
confident ( 41 percent) in the quality of hospital EHR
data. The remaining 30 percent either lack any confidence in the data ( 25 percent) or stated that the data
were rarely complete, accurate, or even available
( 5 percent) (see Figure 4, page 31).
Governors were asked how often they exited the
office or hospital EHR and searched through multi-
ple data sources to obtain all of the information they
needed. With respect to the office EHR, 61 percent of
the respondents said that they rarely or never needed to
exit the EHR for more data. The remaining 39 percent
stated that they needed to exit the EHR for more data
frequently or very frequently (see Figure 5, page 32).
For the hospital EHR, 67 percent of respondents
stated that they rarely ( 55 percent) or never ( 12 percent)
needed to exit the hospital EHR to get data from other
sources, whereas 33 percent stated that they either frequently or very frequently needed to exit the hospital
EHR (see Figure 6, page 32).
Governors were next asked how the use of the EHR
in their office and hospital affected their overall workflow and efficiency. With respect to the office EHR,
67 percent of the respondents said they experienced
either a decrease in efficiency ( 36 percent), a major disruption of previous work flow ( 23 percent), or a severe
disruption of workflow in their office ( 8 percent). In
contrast, 21 percent of respondents reported that their
overall workflow and efficiency in the office had significantly improved, and 12 percent said they experienced
no change (see Figure 7, page 33).
For the hospital EHR, 54 percent of the respondents stated that their overall workflow and clinical
efficiency in the hospital had decreased either slightly
( 33 percent) or significantly ( 21 percent). In contrast,
46 percent reported that their overall workflow and
clinical efficiency in the hospital had either improved
slightly ( 23 percent), improved significantly ( 14 percent), or had not changed ( 9 percent) (see Figure 8, page
34.) It appears that the hospital EHR is less disruptive
to workflow and efficiency than the office EHR.
Rising levels of dissatisfaction
Results from the 2015 ACS Governors Survey clearly
show that Governors have many concerns regarding
the effects EHRs have had on clinical practice. In a
study sponsored by the American Medical Association,
DO YOU USE AN OFFICE EHR?
DO YOU USE A HOSPITAL EHR?