PHOENIX – The “deinstallation” of electronic medical records, or reverting back to paper, is difficult to measure, but one report suggests that Arizona is experiencing an increase in EMR failures that could be followed nationally.

According to a report by HealthLeaders-InterStudy, the state and the Phoenix area have experienced a high adoption rate for electronic medical records, but this has been followed by a deinstallation of the technology.

As much as 20 percent of physician groups in Phoenix are canceling their EMR contracts as a result of training, functionality or affordability issues. This is especially prevalent among smaller physician groups, the report says.

The report said deinstallation due to financial issues is not unique to physician groups or to Arizona. For example, in areas like Miami, where the economic downturn is threatening the profitability of hospitals, adoption of EMRs has been slow because of a lack of funding for capital projects.

Officials at the Arizona Chapter of the Healthcare Information and Management Systems Society question the data suggested in the report. “Our data indicates that we are on par with the rest of the country when it comes to both adoption and deinstallation,” they said.

Brad Tritle, executive director for the Arizona Health-e Connection, a not-for-profit organization that focuses on electronic health records and health information exchange adoption, said he is unaware of any trend in deinstallation in Arizona. In the two-and-a-half years that his organization has been established, he said, they haven’t seen a “flurry of deinstallations.”

The uptake of EMR technology in the Phoenix area and throughout Arizona has been credited to a 2005 executive order by then-Gov. Janet Napolitano that all healthcare providers install EMRs by 2010, the report claims.

According to the Arizona Chapter of HIMSS, the governor’s order did nothing to spur EMR adoption because there was no funding behind it – it was merely a goal.

“Because the Phoenix area has been a real leader in EMR uptake, this is the first market in which we are seeing this deinstallation issue arise, but it likely will not be the last,” said Chris Clancy, market analyst with HealthLeaders-InterStudy. “There’s a physician shortage in Phoenix, so with overcrowded waiting rooms it’s difficult for doctors and their staffs to carve out ample time for training on EMR technology.”

According to Mark R. Anderson, CEO of the healthcare technology advisory and research firm AC Group, Inc., deinstallations are occurring across the country, especially in specialty practices like orthopedics and dermatology.

Anderson said this rate will continue to increase, especially in 2010, because practices will be deinstalling systems that don’t meet CCHIT certification and vendors won’t be able to provide enough technical support to properly train doctors.

He said vendors aren’t training doctors well – it takes them nine times longer to enter data then they would using dictation or handwriting.
“ We have to change the way we train and improve workflow before we get improvement in deinstalls,” he said.