EHR adoption is climbing as a result of national policies designed to encourage widespread use of Health IT such as the HITECH Act. However, adoption is not consistent across all specialties, geographies, and practice sizes — as was recently pointed out in an April 24, 2012, Health Affairs article published online by Decker, Jamoom and Sisk. Click here to read the full article.
The authors analyzed the adoption of EHR systems among office-based physicians from 2002 to 2011 using National Ambulatory Medical Care Survey data. They also examined certain physician characteristics associated with adoption. What they found was that between 2002 and 2011, adoption continued to lag for specific groups of physicians, namely non-primary care specialists, physicians age fifty-five and older, and physicians in small (1–2 providers) and physician-owned practices.
The results are not surprising. The largest market for EHR systems is the primary care segment (General Practice, General Internal Medicine and to some degree, Pediatrics — although this group has some specific needs with respect to documentation and templates). Meaningful Use incentive funding was primarily directed towards encouraging EHR adoption by primary care eligible providers. Feedback from clinicians who have completed EHR satisfaction surveys (through AmericanEHR Partners) demonstrates higher levels of dissatisfaction amongst non-primary care specialists who complain that the EHRs are not designed for their specific workflows. This is particularly apparent in the surgical specialties. Older physicians (55+) may have a more difficult time justifying their investment in health IT and EHR, particularly if they are nearing retirement. Similarly, smaller physician-owned practices are challenged by the cost and complexity of investing in and maintaining technology dependent practices even with the potential benefit of incentive funding.
The bottom line is that there is inconsistency in the adoption and use of EHRs. The authors also point out discrepancies between the adoption of “any EHR” system vs. basic systems that provided the following functionalities — recording patient demographic information, clinical notes, and patient problem lists; viewing laboratory and imaging results; and using computerized prescription ordering. Clearly there is a lot more work needed in order to encourage widespread adoption across non-primary care specialties.
Through AmericanEHR Partners, we will continue to collect and report upon data relating to EHR adoption, satisfaction, and use in order to help clarify many of these questions.
What are your thoughts? Do you believe that EHR adoption will “even out” or will the gaps between primary- and non-primary care specialties continue to grow? Share your opinion.