Blog | Monday, April 30, 2012

QD: News Every Day--3 studies outline who's adopting EHRs, and how fast

A year after Medicare's incentives for using electronic medical records kicked in, small practices, rural hospitals and systems capable of reporting meaningful use criteria still lag in adoption.

Three studies released online in Health Affairs tell the tale.

In the first study, the authors used data from the annual National Ambulatory Medical Care Survey. Overall, there was a 38 percentage point increase in EHR adoption among office-based physicians, and by 2011 more than half of physicians had EHRs, or three tims as many in a decade. But physicians in solo or duo practices were less likely to have made the change (25.9 percentage point increase in adoption rate versus a 54.6 percentage point increase during the decade for practices with 10 or more physicians).

Primary care physicians increased their adoption by 8.6 percentage points more than non-primary care physicians over the decade. Physicians aged 55 and older increased adoption by 20.4 percentage points less than physicians aged 45 years or younger.

The second study found that since the federal incentive program began, the percentage of hospitals with at least a basic EHR system increased from 15.1% in 2010 to 26.6% in 2011. Also, they found that 18.4% of hospitals had achieved what is a reasonable proxy for meaningful use, a large jump from just 4.1% in 2010.

Although there was a 15 percentage point gap in EHR adoption between small and large hospitals in 2010, that gap had widened to nearly 22 percentage points in 2011.

The third study found that while slightly more than half of physicians intended to apply for meaningful-use incentives, only slightly more than one in 10 have EHRs with at least 10 of the 15 capabilities required to support stage 1 core meaningful-use objectives.

The uncertainty is driving small practices to join larger networks of affiliate with hospitals, not only to take advantage of EHRs but because there's safety in numbers. ONE practice's story is reported here.

Finally, many of the same authors from the studies compiled their reports, along with pretty charts and graphs as well as an Interview by Michael W. Painter, MD, JD, of the Robert Wood Johnson Foundation, with David Blumenthal, MD, MPP, immediate past national coordinator of the Office of the National Coordinator for Health Information Technology, in a report here.

Dr. Blumenthal's point of contention: "The first thing such a doctor needs to realize is that he is never going to get help like that available now from the federal government again. That bank is exhausted. The almost $30 billion projected to be spent, assuming that people take advantage of the incentives, amounts to $100 for every man, woman and child in the United States. That is an extraordinary investment by this country in helping doctors adopt a new technology. There is probably not another thing that those doctors will ever do in their lives where everyone walking on the streets in the United States will be paying $100 to help them. If they want to pass that up, that is their right. I don't think it is a very wise decision."