Adoption of Electronic Health Records Still Far from Universal

So you’ve gone ahead and set up an electronic medical records (EMR) system for your practice. But is it compliant? Does it meet “Meaningful Use”?

A new study says no. Published in Health Affairs, the analysis finds a chasm between physicians who intend to apply for electronic health records (EHR) meaningful use incentive payments and the ability of their systems to actually comply with the requirements, according to a story by Health Data Management online.

Researchers from the National Center for Health Statistics and the Institute of Medicine found that 91 percent of almost 4,000 surveyed physicians were eligible for Medicare or Medicaid meaningful use programs, and 51 percent intended to apply.

“But only 11 percent of those who planned to apply had enough EHR capabilities to support up to two-thirds of Medicare’s Stage 1 core objectives,” the story reported.

Nonetheless, the Medicare and Medicaid electronic health record program has so far paid $4.5 billion to almost 80,000 physicians and hospitals in incentive payments through March 2012.

But it’s not totally unexpected that the numbers aren’t higher. The story notes that in the final Stage 1 rule, it was estimated by the Centers for Medicare and Medicaid Services that only 10 to 36 percent of Medicare-eligible professionals and 15 to 47 percent of Medicaid-eligible professionals would be able to demonstrate meaningful use in 2011, according to researchers.

“During 2011, the first year of the incentive programs, almost 124,000 eligible professionals, including physicians, had registered for Medicare incentives, and the Centers for Medicare and Medicaid Services had paid nearly $275 million to 15,000 participants,” the story quoted researchers. “Medicaid meaningful use incentives, which flow through states, totaled about $220 million and went to approximately 10,500 physicians.”

Results “show that a great discrepancy exists between physicians’ intentions to apply for incentives and their readiness to meet even two-thirds of the core objectives for meaningful use.” 

Not surprisingly, another part of the study found a huge lag in EHR adoption between small rural hospitals and their bigger, more well-funded cousins, according to a story by Kathleen Roney.

Pamela Lewis Dolan reports that, although much progress has been made, changes are needed in the way physicians and patients feel about information-sharing and exchange – and in the way the government and payers align incentives. She credits the incentives with jump-starting the move for physicians to meet meaningful use, and writes that 2011 National Center for Health Statistics stats show that 57 percent of physicians use EHRs and 52 percent said they planned to apply for meaningful use incentive money, up from 41 percent in 2010.

Others say meaningful use isn’t enough. Janet Marchibroda, health IT initiative chair for the Bipartisan Policy Center, said many physicians not only lack the technical ability to achieve data exchange, they also lack the incentive, according to Dolan.

But there is good news. Marchibroda told Dolan that the delay in Stage 2 of meaningful use until 2014 will give physicians more time to get up to speed, while Health Analysis study results demonstrate that physicians may be quickly starting to plan to buy new EHRs that will do a better job of meeting the required capabilities.

“Of those intending to apply but not ready, 43 percent reported plans to install a new electronic health record system within the next 18 months.”