Survey Says: EHR Incentive Program Is on Track

Survey Says: EHR Incentive Program Is on Track

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We continue to see progress in improving the nation’s health care system, and a key tool to helping achieve that goal is the increased use of electronic health records by the nation’s doctors, hospitals, and other health care providers. These electronic tools serve as the infrastructure to implementing reforms that improve care – many of which are part of the Affordable Care Act.

Doctors and hospitals are using these tools to reduce mistakes and hospital readmissions, provide patients with more information that enable them to stay healthy, and allow for rewarding health care providers for delivering quality, not quantity, of care.

The adoption of those tools is reflected today in a release from the Centers for Disease Control and Prevention’s National Center for Health Statistics which provides a view of the Medicare and Medicaid EHR Incentive Program and indicates the program is healthy and growing steadily.

The 2013 data from the annual National Ambulatory Medical Care Survey are encouraging:

  • Nearly 80% of office-based physicians used some type of electronic health record system, an increase of 60 percentage points since 2001 and nearly double the percent in 2008 (42%), the year before the Health Information Technology and Economic and Clinical Health Act passed as part of the Recovery Act in 2009.
  • About half of office-based physicians surveyed said they use a system that qualifies as a “basic system,” up from just 11% in 2006.
  • Almost 70% of office-based physicians noted their intent to participate in the EHR incentive program.

Figure 1. Percentage of office-based physicians with EHR systems: United States, 2001-2013

The report also noted that 13% of physicians who responded said they both intended to participate in the incentive program and had a system that could support 14 of the Meaningful Use Stage 2 “core set of objectives,” ahead of target dates. This survey was performed in early 2013 – before 2014 certified products were even available.

The deadline to begin attesting for Meaningful Use Stage 2 is October 2014 for the earliest adopters of Meaningful Use Stage 1, so more than one in ten physicians decided on their own to participate  Meaningful Use Stage 2 capabilities more than a year earlier than necessary. These are early adopters who recognize the benefits of EHRs.

“From 2010 through 2013,  physician adoption of 7 of the 17 capabilities required for Stage 2 core objectives for meaningful use increased significantly,” according to National Center for Health Statistics health-policy researcher and lead author Chun-Ju Hsiao, PhD. Electronic prescribing through an EHR and adverse drug event/contraindication alerts had the largest increase among the stage 2 capabilities, Hsiao wrote.

In 2013, Meaningful Use related functionalities with the highest adoption rates included capabilities for recording key patient health information and functionalities related to medication management and safety. About three-quarters or more of physicians had these types of computerized capabilities.

Notably, physician respondents to another national survey also noted the clinical benefits in using EHRs, including that they helped physicians access records remotely (81%), and alerted providers of a critical lab value (62%). Most importantly, 78% of respondents said that EHRs “overall, enhanced patient care”.

Overall, we are encouraged to see that physician adoption of EHRs meeting Meaningful Use Stage 2 is increasing significantly and that physicians are recognizing the value of EHRs in the care setting.   The report does also tell us there is more to do and we agree. Fewer than one in three respondents (30%) said their EHR facilitated a communication with a patient via e-mail/secure instant messaging.

At ONC we look forward to continuing to work on key issues such as usability and improving functionalities so we can all see the promise of EHRs and health IT to improve care and eventually health.

Figure 2: Percent of physicians with selected computerized capabilities related to Meaningful Use objectives, 2013

Data Source: CDC/NCHS, National Ambulatory Medical Care Survey, Electronic Health Record Survey. Notes: VDT is “view online, download or transmit”. Data represent non-federal office-based physicians providing direct patient care in the 50 states and the District of Columbia, excluding radiologists, anesthesiologists, and pathologists.

Karen DeSalvo, MD, MPH, MSc. is the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. More information about the Office of the National Coordinator for Health IT and health information technology can be found at www.HealthIT.gov

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98 Comments on "Survey Says: EHR Incentive Program Is on Track"


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Guest
Jan 23, 2014

Yes, the EHR incentive program is “on track”. Yet, this doesn’t really mean much.

Computerizing something doesn’t magically fix it.

Giving more info to patients should be a good thing, but then the patients have to actually care about the information and do something with it…this is where the real challenge comes in.

Also, for those who thing MU helps usability…where does this come from?
Ask any end user and they’ll complain about how many times they have to click is different areas just to get one MU “counter”.

Guest
Lucy
Jan 23, 2014

what is PracticeFusion and pharmas doing together? Have you seen their recent press release. http://www.forbes.com/sites/kashmirhill/2013/10/24/practice-fusion-reviews-whoops/

Guest
Jan 22, 2014

My response to this post: http://www.emrandhipaa.com/emr-and-hipaa/2014/01/22/meaningful-use-program-a-success-depending-on-how-you-measure-success/

Needless to say, we all measure success very differently.

Guest
DisillusionedMD
Jan 21, 2014

“Given the recent Robert Wood Johnson Foundation report (Time to Act: —), it appears that the best way to reduce the cost of healthcare is not to invest in HIT but to invest in our communities so as to prevent disease before it happens.”

In other words- our prioritization of investing in physicians, their institutions, and the whole medical model is also misguided. Or do we not like that uncomfortable reading of the data?

Guest
Jan 21, 2014
Guest
DisillusionedMD
Jan 21, 2014

Agreed that policy wonks often focus on the wrong things, though depending on where that wonk sits in the political system they are probably legally bound to base what they focus on on public input, as somebody mentioned earlier in this thread. This really does seem to be the least understood aspect of the American political system- legislators are the only ones who get to just make stuff up. Regulators have highly defined rules for public comment and rule-making within the parameters of a given piece of legislation.

Aside from civics class- I’d say us physicians also pay little more than lip service to this idea of prevention and the creation of healthier communities. Usually that means I want to be reimbursed for counseling on weight loss and exercise, not I think you shouldn’t pay me for that at all and instead should fund easy access to fresh produce and safe environments for everyone to get outside.

We especially don’t like any suggestions that such outreach and services would take place without a physician in charge. God forbid for example we use midwives in a community prenatal and birthing model the way countries with the lowest maternal mortality and morbidity rates do. As if we are taught anything about building a healthy community in medical school beyond hearing the sad statistics, or at best doing a one year fast track MPH.

Guest
Jan 21, 2014

Thanks. Great comment.

Guest
Whatsen Williams
Jan 21, 2014

These entrepeneurial programs are a direct result of the government’s ill conceived rules and laws to control costs: http://www.nytimes.com/2014/01/19/health/patients-costs-skyrocket-specialists-incomes-soar.html?_r=0

Gee whiz, do ya think that doctors are willing to be data clerks and clickers and do windows for the likes of J . Faulkner and N. Patterson, who have sold poorly usable medical devices endorsed by the likes of K. DeSalvo, F. Mostashvitz, and K. Sebelius, under the guise of Meaningful Use?

The programme of HITECH and the embellishments of ONC are ill conceived and cloaked with vendor financial influence, and undoubtedly will have formidable unintended consequences.

Guest
William Palmer, MD
Jan 20, 2014

url correction, I think.
Try this to see commercial uses of feral, escaped, medical data:

Guest
William Palmer MD
Jan 20, 2014

To see the commercial uses of escaped medical data read the registration statement–Form S-1–of IMS Health Holdings,Inc. filed with the SEC, Jan. 2, 2014: http://www.sec.gov/Archives/Edgar/data/1595262/000119312514000659/d628679ds1.htm
Once digital always public.

Guest
Whatsen Williams
Jan 20, 2014

@kdesalvo

Hello Karen:

What are your thoughts about the multi million dollar industry for EHR scribes needed because the EHR tools are poorly usable?

http://www.nytimes.com/2014/01/21/health/an-outdated-solution.html?emc=edit_tnt_20140120&tntemail0=y

Guest
Jan 20, 2014

TO THE EDITOR:

Re “A Busy Doctor’s Right Hand” (Jan. 14): I wholeheartedly agree that scribes could alleviate physician dissatisfaction and let physicians do “the work they went into medicine for in the first place.” But scribes are an expensive and misguided 20th-century solution to a 21st-century problem. The fact that there is such a market for them shows that systems have not been tested adequately for usability.

Electronic health records in their current form are not designed for the workflow of the end user, the physician. Instead of creating a new work force of scribes, health technology vendors should design interfaces that are easy to use and reduce cognitive demands on physicians.

Edward R. Melnick, M.D.

New Haven
__

“health technology vendors should design interfaces that are easy to use and reduce cognitive demands on physicians.”

Well, yeah. That IS what is needed. Everyone knows that. But, a huge part of the problem is the paradigmatic 15 minute office visit. Entering, editing, or just traversing hundreds of data elements comprising FH, SH, PMH, CC, HPI, vitals, active meds list, active problems list, labs, referral reports, ROS etc — all leading to an effective SOAP and accurate coding.

It’s just too much. Productivity treadmill / assembly line medicine.

I think docs should be paid like lawyers, hourly. And paid well, like lawyers — the good docs. When I did the Guardianship I needed on my now-late dementia-addled dad, the attorney was $300/hr (that’s cheap any more). However long it took to assessment the estate financial health and devise an effective “plan,” well, that’s what it took. The whole thing cost me about 4 grand. Had to have it.