By early 2012, few physicians had met meaningful use criteria for electronic health records (EHRs), according to a survey study by Catherine M. DesRoches, DrPH, from Mathematica Policy Research, Cambridge, Massachusetts, and colleagues, published online June 3 in the Annals of Internal Medicine. Furthermore, those who did meet criteria had difficulty using computerized systems for panel management tasks.
“The authors found a lower adoption rate than some others have found…probably because they used a more restrictive definition of an EHR,” David Bates, MD, chief quality officer at Brigham and Women’s Hospital in Boston, Massachusetts, told Medscape Medical News when asked for comment. “Meaningful use is intended to be an escalator, and…more functionality will be required over time. It is too early to expect to see major improvements in care from adoption of EHRs.” Dr. Bates was not associated with the study.
Since 2009, the Centers for Medicare & Medicaid Services have allocated billions of dollars for incentive payments to providers to facilitate EHR adoption and meaningful use. To receive these payments, providers must meet specific criteria as they move through stages of adoption. The goal of this national mailed survey of practicing physicians was to assess physicians’ reports of EHR adoption and ease of use and their ability to use EHRs when evaluating patient care.
In late 2011 and early 2012, 1820 primary care physicians and office-based specialists completed the survey (60% response rate). Less than half (43.5%) of respondents reported having a basic EHR, and only 9.8% met meaningful use criteria. Compared with respondents not meeting this standard, those meeting it were significantly more likely to rate panel management tasks as easy.
Less than half of respondents reported having computerized systems for any patient population management tasks included in the survey. Those who did have them reported variability in their ease of use.
“Few physicians could meet meaningful use criteria in early 2012,” the authors write. “Among those meeting the standard, using computerized systems for the panel management tasks were difficult. Results support the growing evidence that using the basic data input capabilities of an EHR does not translate into the greater opportunity that these technologies promise.”
Study Limitations and Implications
Strengths of this study that were noted by Dr. Bates include the use of a representative national sample and collection of data about EHR content.
“One limitation is that the data are already a year and a half old, and providers appear to be adopting rapidly,” said Dr. Bates, who is also a member of the Brigham HIT Policy Committee and Meaningful Use Subcommittee. “The data about payment show that nearly all providers who have applied for meaningful use have been successful.”
Other limitations noted by the study authors include potential response bias and the inability to verify the accuracy of respondents’ reports.
“I think that meaningful use is on a good trajectory,” Dr. Bates concluded. “More research is needed about whether care improves as additional functionality is required, and whether [it] is associated with higher quality and/or lower costs of care, [especially] in situations in which payment mechanisms are well aligned. We also need better tools within EHRs to improve care coordination, and more studies of the benefits of personal health records.”
