EHR Progress In The Medical Practice
By Ken Congdon, editor in chief, Health IT Outcomes
I'm not sure which is increasing at a faster pace — EHR adoption rates or studies about EHR adoption rates. The latest in a string of EHR-related studies, titled Electronic Health Records: Status, Needs, and Lessons 2011, was released a few weeks ago by MGMA (The Medical Group Management Association). This report analyzes 4,588 online EHR survey responses from medical group practices representing approximately 120,000 physicians, and provides a snapshot of the EHR adoption trends and barriers for medical practices.
The following are a few of the key data points revealed by the study:
- 80.1% of medical practices have already adopted an EHR
- 72% said they are satisfied with the EHR system overall
- However, only 13.6% of medical practices indicated that they are currently able to meet all 15 core criteria for meaningful use
- 26.5% of practices indicated that productivity increased as a result of the EHR
- 30.6% of practices indicated that productivity decreased as a result of the EHR
- 42.9% of practices indicated the EHR had no impact on productivity
- 38.4% of practices indicated that operating costs increased as a result of the EHR
- 25.9% of practices indicated that operating costs decreased as a result of the EHR
- 35.7% of practices indicated the EHR had no impact on operating costs
- Of the practices still using paper records, 28.8% indicated they were in the process of selecting an EHR system
- The top barriers to EHR adoption are insufficient capital resources (71.7%), perceived productivity loss (67.4%), and insufficient expected ROI (56.9%)
Reaction To The Study
I found this MGMA study compelling for a number of reasons. First, I was a bit surprised by how many medical practices have already implemented an EHR. I would have guessed that more than 20% of practices were still using paper records. I base this assumption only on personal experience and the experiences of family and friends.
Second, I was also surprised by the EHR satisfaction figure revealed by the study. 72% of practices said they are satisfied with their EHR system overall, yet only 26.5% indicated a productivity increase and only 25.9% indicated a decrease in operating costs as a result of the system. Furthermore, only 13.6% of medical practices believed their current EHR system would allow them to meet all core meaningful use criteria required to receive incentive payments. So, I ask you — what is it about the EHR that is satisfying to these medical practices? Maybe it's just me, but I wouldn't be too satisfied with a technology investment that cost my practice money year over year and drove down my productivity. This was a discrepancy in the data that didn't make sense to me.
Third, I would have guessed that medical practices owned by hospital systems are more likely to have a fully implemented EHR in place than independent medical practices. However, the MGMA study indicates that the opposite is true. This floored me. In a press release about the study, MGMA Innovation and Research Vice President David Gans gave the following rationale for this interesting finding:
"Hospital-based practices have access to the information resources of their parent health system, which would normally imply that these practices would be further along toward optimization. However, integrated systems are much more complex environments than independent physician practices and their information systems often have to encompass both in-patient and physician components. The added complexity, combined with the geographic dispersion of most hospital-based physician practices, has hindered the advancement."
Finally, the barriers to EHR adoption didn't surprise me. These hurdles have been well documented in other studies and by the healthcare industry at large. However, I did find it interesting that only 28.8% of practices still using paper were in the process of selecting an EHR system. What are the plans of the other 71.2% of paper-based practices? How long do they plan on waiting to begin their EHR initiative? Or, do they have no plans to transition? In any case, I encourage you to download the full version of the MGMA report, particularly if you're responsible for the EHR initiatives of your medical practice. It should provide a decent barometer of where you stand among your peers in terms of EHR adoption and meaningful use.
Ken Congdon is Editor In Chief of Health IT Outcomes. He can be reached at ken.congdon@jamesonpublishing.com.