Electronic health records move into the mainstream, thanks to Meaningful Use incentives. Most successful practices invest more in training, advanced functions, research shows.
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Physicians are starting to embrace electronic health records en masse, according to a new survey by the Medical Group Management Association (MGMA). Two caveats to bear in mind: Many of the EHRs in use still have minimal functionality, and the MGMA survey excluded solo and two-doctor practices.
According to the report, Performance and Practices of Successful Medical Groups, 51% of groups of three or more physicians are using some kind of EHR. Similarly, a recent government survey found that in 2011, 57% of office-based physicians had an EHR. But 34% of the respondents had what the government researchers defined as a "basic EHR." A basic EHR includes only a patient's medical history, demographics, diagnoses, medications, and allergies, as well as the ability to prescribe and view lab and imaging results electronically
Likewise, the MGMA poll found that around half of the EHRs used by their members lacked many key functions. For example, only 56% of MGMA survey respondents with EHRs said their system could generate problem lists; 49% had EHRs that provided drug interaction warnings.
However, with the advent of Meaningful Use, many physicians are switching to more capable EHRs to qualify for government financial incentives, noted Todd Evenson, assistant director of survey operations, MGMA-ACPE, in an interview with InformationWeek Healthcare. Meaningful Use, he said, "ensures that EHR systems are meeting their needs at several different levels of basic functionality."
More respondents from the most successful practices (when compared to less successful groups) said their EHRs had advanced functions. And 57% of better performers had fully implemented EHRs, compared to 42% of other practices.
The latter finding doesn't necessarily show a direct correlation between EHR adoption and the degree of practice success, Evenson cautioned. Many of the better performing practices, he pointed out, were early adopters of EHR technology, but that was only one of the factors that led to their success. Nevertheless, he added, "for those who've been ahead of the curve, the data suggests that their performance is being positively impacted by EHR implementation."
The MGMA survey results indicate that EHR adoption is becoming widespread. Besides the 51% of practices that had fully implemented systems, 15% were in some stage of implementation. About 8% were storing transcribed notes electronically, and 4% were scanning documents into a document management system. Only 25% said they were still exclusively using paper records.
A similar picture emerges from the MGMA data on groups that have not yet installed EHRs. Nearly 17% were in the process of implementation, 14% planned to adopt EHRs within the next 12 months, and 8% planned to do so within 24 months. Another 8% hadn't implemented an EHR, but only 2% had no plans to do so.
Evenson said the government incentive program has been the biggest driver of EHR adoption. "The key is that physician practices and health systems are recognizing those Meaningful Use dollars are available to them. Obviously, in an environment constrained by rising costs, they're looking for every opportunity to improve revenue."
At the same time, he said, physicians increasingly recognize that properly implemented EHRs can pay for themselves in the long run. "We've looked at some of our other EHR reports, and the data suggests there is a positive return on investment for EHRs themselves," noted Evenson. "And we're seeing the full impact of that moving forward."
The better-performing practices spent about $30,000 per physician on their EHRs, whereas other practices averaged about $20,000. This is not because the successful groups had more expensive EHRs, said Evenson. It is because the better performers spent more money on training and implementation, which are key to EHR success, he noted.
"An EHR can have advanced functionality, but if the staff and the physicians don't know how to utilize the product, it makes no difference whether it can perform a function or not," he pointed out.
The better performers spent slightly more than other groups did on maintenance of their EHRs--$540 per provider per month vs. $500 per month. But Evenson didn't attach any significance to that difference. The maintenance figures, he added, include subscriptions to cloud-based EHRs as well as software maintenance fees for purchased systems.
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