Ambulatory EHR Adoption
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Ambulatory EHR Adoption

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I did a metanalysis of EHR adoption studies. These were the results as presented on September 15, 2010.

I did a metanalysis of EHR adoption studies. These were the results as presented on September 15, 2010.

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Ambulatory EHR Adoption Presentation Transcript

  • 1. Ambulatory Electronic Health Records Adoption Trends 2005-2010Jessica JacobsSeptember 15, 2010
  • 2. What does Ambulatory Mean? • Ambulatory providers are physicians who perform the majority of their services outside the hospital – No more than 90% of their services are performed at a hospital • Currently there are 200,0000 physician offices, 515,000 total practicing ambulatory physicians*https://questions.cms.hhs.gov/app/answers/detail/a_id/9844/~/[ehr-incentive-program]-are-physicians-who-practice-in-hospital-basedNote: Excludes radiologists, pathologists, anesthesiologists, ER and all other hospital-based physicians
  • 3. In other words…Them Not Them
  • 4. What is an EHR?• An Electronic Health Records (EHR) is “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.” – HIMSS, 2010• Colloquial Definition – Computer records in a doc’s officesthat can talk to pharmacies, has decision support, talks tohospitals, improves quality, decreases costs, and saves the world
  • 5. Adoption Definitions 44% 21% 6% •Any EHR •Patient •All Basic Basic FullAny Adoption Demographics Requirements •Problem Lists •Medical •Clinical Notes History/Follow •Rx Orders Up •Lab Results •Test Orders •Imaging •Rx/Test Orders Results sent Electronically •Drug/Drug Interactions
  • 6. EHR Adoption Rates Accenture, Any (Small Practices)50.00% xxx, Any (Internal Medicine)45.00% Kemper, Any (Pediatricians)40.00% Modern Medicine, Any (PCP)35.00% NAMCS, Any30.00% Simon et al, All (Physician Practices)25.00% SK&A, Any20.00% DesRoches, Basic (All Physicians)15.00% NAMCS, Basic10.00% Accenture, Full (Small Practices) DesRoches, Full 5.00% NAMCS, Full 0.00% 2004 2005 2006 2007 2008 2009 2010 2011
  • 7. Adoption Definitions 44% 21% 6% •Any EHR •Patient •All Basic Basic FullAny Adoption Demographics Requirements •Problem Lists •Medical •Clinical Notes History/Follow •Rx Orders Up •Lab Results •Test Orders •Imaging •Rx/Test Orders Results sent Electronically •Drug/Drug Interactions
  • 8. HITECH… and Meaningful Use• The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was a part of ARRA• Allocated funds to spur the adoption of electronic health records - mostly administered through ONC and CMS• Incentive Payments for Meaningful Use are administered through CMS – Medicare: Maximum Incentive = $44k/physician – Medicaid: Maximum Incentive = $63k/physician – Incentives will be paid 2011- 2016, then penalties will begin• Meaningful Use Rules were released July 13, 2010
  • 9. Basically…
  • 10. EHR Adoption Rates50.00% Accenture, Any (Small Practices) xxx, Any (Internal Medicine)45.00% Kemper, Any (Pediatricians)40.00% Modern Medicine, Any (PCP)35.00% NAMCS, Any30.00% Simon et al, All (Physician Practices)25.00% SK&A, Any20.00% DesRoches, Basic (All Physicians)15.00% NAMCS, Basic10.00% Accenture, Full (Small Practices) 5.00% DesRoches, Full 0.00% NAMCS, Full 2004 2005 2006 2007 2008 2009 2010 2011
  • 11. Key Take-Aways• The rates of ambulatory adoption have risen significantly over the past five years• Unfortunately that increase in adoption has not translated into “meaningful” adoption• The current rate of meaningful adoption is 6.3%, hopefully new rules and certifications will help increase this percentage