Clinical Communication Gaps Persist Despite EHR Adoption

Comparing survey data from 2008 with 2019 results revealed that widespread EHR adoption has not improved clinical communication gaps between PCPs and specialists.

Despite widespread EHR adoption, clinical communication gaps between primary care physicians (PCPs) and specialists persist, according to a study published in the Annals of Family Medicine.

Poor communication has been associated with delayed diagnoses, unnecessary testing, and patient and physician dissatisfaction. 

Comprehensive Primary Care Plus (CPC+) model survey data from 2008 revealed sizable gaps in communication among physicians caring for mutual patients.

Researchers compared these results to 2019 CPC+ survey measures and found that PCPs still do not consistently communicate with specialists.

Since CPC+ has different entrance requirements for each of its two tracks, with more advanced care delivery requirements and payment approaches for track two, the authors analyzed practices separately by track.

In each of the tracks, 22 percent of PCPs reported that they either “sometimes” or “seldom or never” share clinical information with specialists at the time of a referral.

Additionally, 35 percent of track one and 33 percent of track two PCPs reported that they either “sometimes” or “seldom or never” receive information back from the specialist after a consultation.

“Gaps in communication between PCPs and specialists persist,” the researchers wrote. “Because physicians participating in the CPC+ survey are a highly motivated subset and are in practices with relatively more sophisticated EHR use, actual communication behaviors nationwide are likely worse than what we found in the present research sample.”

“Because these are physician-level proportions, the number of patients who are potentially affected is large,” they continued. “Further, the presence of any communication between providers does not guarantee that practitioners are sending or receiving the optimal information needed for clinical decision making.”

While the study’s sample is not directly comparable to the national sample of practices examined 11 years ago, the similarity in findings suggests that physicians still do not always communicate regarding referrals despite more available clinical data.

“Our findings underscore the need for granular measurements of how communication is changing,” the researchers said. “It is not enough to assume that putting EHRs in place will improve communication; changes in communication need to be measured.”

They also noted that further research is needed to understand communication challenges between PCPs and specialists, despite the availability of health IT to aid communication and incentives to enhance care coordination.

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