ONC: Physicians' EHR Capabilities Growing Rapidly

Physicians have sharply increased their ability to use electronic health records and other computerized tools to improve the quality, safety and coordination of care, according to a new report from the Office of the National Coordinator for Health IT (ONC).

The report, however, paints a rosier picture of physicians' EHR capabilities than was presented in a report issued last week by the National Center for Health Statistics (NCHS), a unit of the Centers for Disease Control and Prevention (CDC). The reports used the same data to reach their conclusions.

According to the ONC report:

-- Within the past year, the percentage of physicians who have the computerized capability to provide after-visit care summaries to patients increased from 46% to 56%.

-- The number of physicians who can e-prescribe has doubled since 2009, and two thirds of physicians now have the capability in their EHRs to use electronic medication lists and drug interaction checks.

-- Half or more of physicians report having the ability to use their EHRs to meet 12 of the 15 core objectives in Meaningful Use stage 1.

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The NCHS report found that 66% of physicians planned to participate or were participating in the government's EHR incentive program. Of those doctors, just 27% said they had EHRs capable of meeting 13 of the 15 core objectives. That's a far cry from the 50% of doctors who said they could comply with 12 of the 15 core objectives, according to ONC.

It's unclear which one of the 13 goals that NCHS considered was left out of the ONC analysis. But it's likely that it was the ability to use the EHR to produce data for clinical quality measures. Only 43% of the respondents to the National Electronic Health Records Survey, which supplied the information for the dueling reports, said their EHRs could generate this data.

Catherine DesRoches, senior survey researcher for Mathematica Policy Research, said she found the ONC data "a little bit difficult to understand, particularly when it comes from the same data set as the NCHS data."

For example, she noted, only 40% of the physicians said they had a basic EHR system, as defined by NCHS. Such an EHR can meet most but not all of the criteria for Meaningful Use, so it was a bit hard for DesRoches to comprehend how 50% of physicians could have the capabilities to meet most of the core objectives.

"It doesn't seem likely to me that you could have more people meeting the requirements for Meaningful Use than could meet the basic [EHR] standard," she said.

Referring to the mismatch between the percentages of physicians saying their EHRs could meet most Meaningful Use criteria in the two reports, she said, "The difference is likely due to what's in the ONC definition vs. what's in the NCHS definition."

In any case, she noted, the real test will be how many physicians manage to attest to Meaningful Use in the long run. "And that test is going to get harder. The first set of criteria, where [doctors] say, 'yes, my system can do this' but don't need to be doing it, is the lowest bar. As Meaningful Use goes through the various stages, they'll have to actually demonstrate it. That's where we'll get a sense of what the true numbers are."

An ONC spokesman told InformationWeek Healthcare there was no discrepancy between the two reports. But the authors of the ONC brief could not be reached for comment at press time.

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