Issue: March 2011
March 01, 2011
3 min read

CDC survey shows half of office-based physicians using EMRs

Issue: March 2011
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Some cite financial incentives from the government as driving this trend. Greater increases in use may come during the next 2 years.

The preliminary results of a survey conducted by the CDC’s National Center for Health Statistics show that 50.7% of nonfederal office-based physicians are using electronic medical record/electronic health record systems and 10.1% of physicians have “fully-functional” systems.

The preliminary 2010 data represent a twofold increase in the overall use of electronic medical record (EMR)/electronic health record (EHR) systems by these physicians since 2005. Although the survey did not explore why this increase occurred, study investigator Chun-Ju Hsiao, PhD, said it is likely that this trend would continue due to recent federal programs that provide financial incentives for implementing these systems.

More than 10,000 surveyed

To determine the EMR/EHR use among office-based physicians, Hsiao and her colleagues surveyed 10,301 physicians between April and July 2010 by mail and follow-up telephone calls. The investigators had an unweighted response rate of 68%.

The preliminary 2010 data revealed that 24.9% of respondents had systems that met the criteria of a “basic” system, which include features such as capturing patient history and demographics, computerized orders for prescriptions, and the ability to view lab and imaging results. This figure increased 14.2% compared with 2009 data.

The investigators also discovered a 46.4% jump between 2009 and 2010 in the number of physicians who reported having “fully-functional” systems, which include features such as drug interaction warnings, medical history, and guideline-based interventions. In addition, the 2010 survey results showed that overall EMR/EHR use varied by state, ranging from 38.1% for Kentucky to 80.2% in Minnesota.

‘Pulling the trigger’

Rosemarie Nelson, principle of the MGMA Health Care Consulting Group, said that she was not surprised that most physicians are using the systems. “The real story here is about only 10% [having fully functional systems],” she said in an interview.

She said that federal incentive programs and benefits in practice workflow are driving EMR/EHR adoption and noted an increase in clientele for these systems.

“In the past, there was interest, but the decision was no decision,” Nelson said. “Now, we are seeing physicians pull the trigger.”

Rate of adoption, barriers

While more physicians are implementing these systems, Randale C. Sechrest, MD, an orthopedic surgeon with more than 20 years of experience with EMRs, said that the rate of embracing electronic information lags behind those of other professions. “I would argue that given the impact the Internet has had on every other business sector, EHR adoption of 50% is incredibly low.” Sechrest said in an interview.

EHR adoption among physicians has not occurred as fast as some industry experts thought, he said. “Remember that some very big players, thought they were going to accelerate the digitization of health records and failed miserably.”

Sechrest cited interoperability and a lack of standards as the greatest barriers to implementing these systems. “The standards associated with the web browser are what drove the rapid rise of the public Internet,” he said. “What if there were 400 competing web browser interfaces and data models for storing information? We would still be mired in dysfunction. That is the situation with EHR in recent history leading to today. One only needs to look at the numerous interfaces of the PACS software to see an example. I have to learn a new software interface every time I get a disc from outside my institution. Even with the dicom standard, the images on that disc may or may not be readable from my own PACS software viewer.”

Future trends

He expects a significant increase in use during the next 2 years, due to government incentives and penalties for continuing with paper-based systems.

“Once a critical mass of users is actually communicating with other interoperable EMRs, the terrain will change dramatically,” Sechrest said. “Having an EMR in your office is like having a computer before the Internet. Great storage device, but it does not allow you the benefits of communicating with other computers and servers. Having an interoperable EMR with the peering agreements in place to share data is the real game changer. That will be more comparable to the situation that arose after the public Internet became available.”

Sechrest also predicts consolidation in the market place. “I do not think we are to the point where there is a clear winner in terms of a vendor that is providing a clearly superior system, nor have we yet reached a set of standards that are stable.” – by Gina Brockenbrough

For more information:

Disclosures: The investigators report no relevant financial disclosures.

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