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This survey included AMGA members and non-members and was designed to understand the experience of physicians and mid-levels regarding the implementation and utilization of Electronic Health Record ...

This survey included AMGA members and non-members and was designed to understand the experience of physicians and mid-levels regarding the implementation and utilization of Electronic Health Record and Practice Management systems, with a particular focus on identifying the key success factors to capturing the benefits offered by these critical tools.

The data provides a very rich sample from which to draw conclusions on the factors that distinguish groups that derive the greatest benefits from their EHRs from those that are still struggling to capture the potential value represented by these increasingly ubiquitous tools.

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Final  A  Gurvey Report V4 Ppt Final A Gurvey Report V4 Ppt Presentation Transcript

  • E lectr ic H ealth R ecor s: on dKeys to Ach ievin g Value an d I p r g C ar m ovin e
  • About th e SurveyDuring Q2 2009, the American Medical Group Association (AMGA)conducted a survey with the help of the JHD Group, a physician practicemanagement, office technologies, and healthcare managementconsulting firm. This survey included AMGA members and non-membersand was designed to understand the experience of physicians and mid-levels regarding the implementation and utilization of Electronic HealthRecord and Practice Management systems, with a particular focus onidentifying the key success factors to capturing the benefits offered bythese critical tools.Survey invitations were sent to several senior leaders in eachorganization. The AMGA members were strongly interested in sharingtheir experiences, as evidenced by the 52% response rate from the 309member organizations that submitted at least one response. At many ofthose groups, multiple leaders submitted responses. Additionally, 39surveys were submitted by physicians and top administrators of large,non-member medical groups.This data provided a very rich sample from which to draw conclusions onthe factors that distinguish groups that derive the greatest benefits fromtheir EHRs from those that are still struggling to capture the potentialvalue represented by these increasingly ubiquitous tools. 2
  • About AM G A an d J DG H The American Medical Group Association (AMGA) represents medical groups, including some of the nations largest, most prestigious medical practices, independent practice associations, and integrated healthcare delivery systems. AMGA improves health care for patients by supporting multispecialty medical groups and other organized systems of care. The members of AMGA deliver health care to approximately 96 million patients in 49 states. Headquartered in Alexandria, Virginia, AMGA is the strategic partner for medical groups providing a comprehensive package of benefits, including political advocacy, educational and networking programs and publications, benchmarking data services, and financial and operations assistance. www.amga.org JHD Group is a leader in assisting physician organizations to meet the challenges of care delivery, managed care, technology, compliance, and patient services. The JHD Group focuses on driving the operational excellence and financial results that clients seek through their expert comprehensive clinical integration, management consulting, and practice management services. www.jhdgroup.com 3
  • Dem ogr h ics apResponses to the survey primarily came from larger (+100 physician and midlevel FTE) groups that have beenutilizing EHRs in their practices for 3 or more years. This 59% level of “long-term” (>3 years) EHR use is muchhigher than the rates reported by most of the surveys being published regarding EHR adoption among USphysicians. It also reflects the position of the AMGA member organizations as industry leaders in informationtechnology use, complemented by their historical and recognized leadership in clinical services. 4
  • E xecutive Sum m ar ySever m aj th em es em er f om th e r on se d ata. al or ged r esp1. H ealth car p r ession als view E H R s as both an im p or t tool an d a sign if tin vestm en t e of tan ican th atis cr itical to th e f e success ofth eirgr s. E xp ectation s ofth e ben ef ofer by utur oup its f ed E H R s ar both br an d d eep . Th ey in clud e sup p or g im p r e oad tin ovem en ts in clin ical q uality, p atien tser vice, op er ation al eficien cy, f an cial p eror an ce th r f in f m ough m an agin g r or isk cap tur g in cen tive r in even ues, an d m ar p osition . ket2. Tod ay’E H R system s r uir substan tial tim e f tr in g, p lan n in g, an d custom iz s eq e or ain ation to m eetth e var n eed s ofd ifer t sp ecialties an d d ifer tly con f ed p r ied f en f en igur actices. Ad d ition ally, im p lem en tation ofan E H R system r uir substan tial in vestm en tabove an d eq es beyon d th e licen sin g an d tr in g costs in or erto d eliverth e f p oten tial.System ain d ull im p lem en tation s ar h igh ly d isr tive an d r e up esour - ten sive. Th ey sh ould be car ully ce in ef p lan n ed to en sur a successf laun ch . e ul3. C ap tur g th e p oten tial ben ef f om an E H R is an on goin g efor an d even th e m ost in its r f t successf user h ave cap tur on ly a p ar ofth eirexp ected an d d esir ben ef Th ese ul s ed t ed its. ben ef on ly r its esult af wor low r esign , ad j ter kf ed ustm en ts to th e d ivision oflaborstaf / f utilization , an d exp an d in g utilization ofth e system cap abilities.4. E xp er ce br s op tim ism . G r s alm ostun iver ien eed oup sally r or in cr ep t eased exp ectation s f or th e value d eliver by E M R system s acr a var off ed oss iety eatur an d f ction s, even bef e es un or th ose gr s h ave cap tur th e ben ef th ey exp ected th e system s to d eliverp r to oup ed its ior Optimism im p lem en tation .1. O n goin g ed ucation an d tr in g is cr ain itical to r in g th e ben ef ofer by E H R s. E ven am on g gr s with selfr ealiz its f ed oup -ated h igh ach ievem en tan d h igh exp ectation s ofth eirsystem s, th er r ain s con f e em usion (in clud in g at th e lead er ip level)ofwh at th eirsystem s sh ar curen tly cap able ofd eliver g to th e gr s. e r in oup2. Patien ce an d p ersisten ce ar am on g th e m ostcr e itical success f actor Th e gr s cap tur g th e m ostben ef f om th eirE H R system s s. oup in its r ar th ose wh o in tr uce f ction ality in stages, allow tim e f th e p h ysician s an d staf to d evelop p r icien cy in subsets ofcap abilities e od un or f of at a p ace th ey ar able to absor an d p lan car ully f th e r e b, ef or ollout/exten sion ofsystem f ction ality. G r s with th e gr atest/ gest un oup e lon exp er ce with th e system s (e. , >5 year ar also th ose with th e gr ien g. s) e eatestsuccess in cap tur g ben ef an d satisf in its action with th eir E H R system s. 5
  • O p er ation s an d Q ualityHas your practice experienced any of the following changes in healthcare deliverythat can be attributed in part or in full to use of an EHR? (check all that apply) 0 20 40 60 80 1 00 1 20 In tra- e com m s m ore effic ien t/ reliable offic M ore flexibility/ rem ote ac c ess Patien t problem s addressed m ore effic ien tly eRx = reduc ed call bac k s from ph arm ac ies E& M codin g is m ore ac c urate eRX = avoidin g adverse drug ev ts en Ch ron ic disease rem in ders/ m an agem en t Better c h arge capture O th er 6
  • E volution M od elBen ef an d Value itsch an ge an d in cr easein com p lexity overtim e 7
  • M ean in gf U se ulDem an d s ofgover m en t an d p ayerp r am s will in cr n ogr easean d becom e m or com p lex overtim e e HIT Enabled Health Reform 8
  • Poten tial U p Sid eE xam p le:a 20 0 p h ysician gr r p up to ach ieve “ m ean in gf use” oup am ul Number of Physicians Effectively Using EHR Payment Year 2011 2012 2013 Total 80 80 HIT Enabled Health Reform 40 200 2011 $1,440,000 $1,440,000 2012 960,000 $1,440,000 $2,400,000 2013 640,000 960,000 600,000 $2,200,000 2014 320,000 640,000 480,000 $1,440,000 2015 160,000 320,000 320,000 $800,000 2016 160,000 160,000 $320,000 $3,520,000 $3,520,000 $1,560,000 $8,600,000 9
  • E H R I tegr n ationThe majority of respondents indicated that their EHR systems were integrated with a Practice Managementsystem. The majority of respondents do utilize ePrescribing and most programs are integrated with the EHR.Slightly more than half of respondents do utilize a Patient Registry, but only a third have an integrated capability. eRx in tegrated w ith EHR Patien t Registry in tegrated w ith EHR 140 133 140 120 120 10 0 10 0 80 80 64 64 60 60 47 42 40 40 18 17 20 20 1 0 0 Don ’ N o Pt. Yes but n ot t Yes but n ot No y eR x Don ’Kn ow Kn ow R egistr ated ated Yes an d ated ated Yes an d in tegr in tegr in tegr in tegr t 10
  • Data C ap tur eThe survey results and follow-up interviews clearly indicate that the ability to access extensive patient data quicklyis an early and significant benefit from implementing an EHR. This observation is supported by the fact thatmultiple data sets are currently being captured in most EHR systems. E xter al sp ecialist r eral r ts n ef r p I tr or n a- gtaskin g d ata I ter al sp ecialist r eral r or n n ef r ep ts R ad iology/m agin g tests I C lin ical n otesPatien t p r oblem , m ed s, aller lists gies L abor y tests ator Patien t d em ogr h ics d ata ap 0% 20 % 40 % 6 0% 80 % 10 0 % C ap tur g tod ay in Plan to cap tur w/ 2 yr e in s Plan to cap tur w/ 5 yr e in s N o p lan s to cap tur e 11
  • Sh ar g C om p utable Data in We wanted to understand whether systems were simply sharing data in a digitized format, like a pdf, or whether they were transmitting computable data that could be manipulated in the EHR system. Survey results indicate that laboratory information has a high level of computability, followed by radiology reports and pharmacy records. Hospital inpatient and discharge information is not generally transmitted in a computable form.Hospitals - h arge data discHospitals - patien t data in Ph arm ac y Radiology Labs 0% 1 0% 20% 30% 40% 50% 60% 70% 80% 90% 1 00% 12
  • U se ofE H R DataOne of the widely heralded features of an EHR is the ability to report data that can be used to meet payer,government ,or internal performance guidelines.More than half the respondents indicated that they are currently using their output to support improved coding,incentive programs, patient case management, and adherence to protocols. More than 95% do so now or plan to doso within 2 years.About a quarter of respondents were using their output for more complicated programs such as demonstrating clinicalcost effectiveness, looking at longitudinal patient data, or clinical research and trials.Fewer than 10% are currently able to do evidence-based predictive modeling and more than 40% plan to wait 5 yearsor have no plans to do so. P4P,PQRI,HED IS etc . Im prov g c lin icalcodin g in Clin icalguidelin es an d/ or protocols In dividualpatien t case m an agem en t Clin icaltrials or researc hLon gitudin alv s of patien ts an d population s iew D em on stratin g c lin icalcost effec tiv ess en Ev c e- iden based predic tiv m odelin g e 0% 20 % 40 % 6 0% 80 % 10 0 % U sin g tod ay Plan to use w/ 2 yr in s Plan to use w/ 5 yr in s N o p lan s to use 13
  • Str ategic I p or ce ofE H R m tanSurprisingly, while garnering incentives is a strategic imperative for nearly 40% of respondents, quality, efficiency,and service are rated as much more critically important to these organizations.In fact, market positioning for providers was rated as slightly more important than incentive revenues.R isk orin cen tive r even ue M ar p osition ket Patien t ser vice O p er ation al eficien cy f C lin ical q uality 0% 20 % 40 % 6 0% 80 % 10 0 % Cr itically im p or t tan I p or t m tan N eutr al L ow im p or ce tan N ot im p or t tan 14
  • E xp ectation s v.R esultsRespondents were asked to indicate the level of expectations for various benefit categories shown below. The inquiryexplored expectations from the start of implementation, how much they felt they had achieved at the time theyresponded to the survey, and what their ultimate level of expectations were at the time of the survey.Overall, expectations across all categories were highest to high going in to an EHR implementation and as theimplementations continued or were completed, expectations actually rose significantly for future achievement of benefits. BetterAccess to M ed ical R ecor s d BetterPatien t Follow up Full p ictur ofth e p atien t e R ed uction in M ed ical E ror r s I pr m oved coor in ation ofcar an d r erals d e ef r Betterability to p lan an d execute in ter tion ven I pr m oved M D p atien t com m un ication I pr m oved case/ igh r m an agem en t h isk I pr m oved use ofguid elin es an d p r otocols Dem on str ated C lin ical C ost efectiven ess f I pr m oved r or g ofp atien t com p lian ce ep tin Lowest Low Med Hi Highest Pre Implementation Expectations Current Expectations for Future Achieved at Time of Survey 15 Ford etailed r esults see ap p en d ix
  • C on clusion s § Work toward a team model that gets everyone working at the top of their licensure including physicians § Focus on clinical outcomes § Invested the time and resources required § Maintain a persistent focus on fully integrating the emerging system 16
  • Ap p en d ix17
  • All R esp on ses1. How many FTE providers (physicians and mid-levels) are in your organization?Value Count Percent101 - 250 87 0.3751 - 100 51 0.22251 - 500 37 0.16> 500 32 0.1421 - 50 20 0.09Less than 20 8 0.03Total Responses: 2352. Does your organization use an Electronic Health Record (EHR) system?Value Count PercentYes 201 0.86No 34 0.14Total Responses: 2353. Does your organization plan to implement an EHR system in the future?Value Count PercentYes, within 2 years 28 0.82Yes, within 5 years 5 0.15Not Sure 1 0.03Total Responses: 344. When did your organization start to utilize your current Electronic Health Record (EHR) system?Value Count Percent5-10 years ago 49 0.253-5 years ago 42 0.212-3 Years ago 33 0.171-2 years ago 29 0.15More than 10 years 25 0.13Less than 1 year ago 20 0.1Total Responses: 198 18
  • All R esp on ses (C on t.)5. Is your EHR integrated with a Practice Management System?Value Count PercentYes 135 0.68No 30 0.15Not sure 8 0.04Other 25 0.23Total Responses: 1986. Does your organization use a Patient Registry and if so, is it integrated with an EHR?Value Count PercentNo, we do not use a Patient Registry 81 0.35Yes, we use a Patient Registry and it IS integrated with an EHR 76 0.33Yes, we use a Patient Registry but it is NOT integrated with an EHR 55 0.24Not sure 21 0.09Total Responses: 2337. Does your organization use ePrescribing capabilities and if so, are they integrated with an EHR?Value Count PercentYes, we use ePrescribing and it IS integrated with an EHR 159 0.68No, we dont use ePrescribing 53 0.23Yes, we use ePrescribing but it is NOT integrated with an EHR 20 0.09Not sure 3 0.01Total Responses: 2358. Does your ePrescribing capability address requirements for Medicare 2009 e -Prescribingincentive program such as the following: (check all that apply)Value Count PercentAbility to select medicines, print prescriptions, electronically transmit prescriptions, and conduct all alerts 158 0.91Complete active medications list, incorporating data received electronically from pharmacies and pharmacybenefit managers (PBMs) 92 0.53Ability to easily identify lower cost, therapeutically appropriate alternatives (e.g., tiered formularyinformation) 87 0.5Patient specific concurrent formulary and authorization requirements (received electronically from PBM) 55 0.32Other 17 0.17Total Responses: 174 19
  • All R esp on ses (C on t.)9. Does your EHR solution include any of the following? (check all that apply)Value Count PercentPatient portal / Secured patient communications 84 0.66Physician portal (physician to physician) 84 0.66Community Health Exchange 12 0.09Other 10 0.1Total Responses: 12710. Does your Patient Portal give your patients the ability to: (check all that apply)Value Count PercentRequest prescription refills 71 0.87View lab results 59 0.72Schedule appointments 46 0.56Update their demographic information 45 0.55Access a personal health record 43 0.52Complete 1st time visit paperwork 32 0.39Update their insurance information 29 0.35Complete patient satisfaction surveys 12 0.15Have access to formulary for patient benefit plan 4 0.05Other 14 0.14Total Responses: 8211. LabsValue Count PercentDigital (computable) send and receive 143 0.76Digital (computable) receive only 35 0.19No digital interaction (uses fax, hard copies, etc.) 4 0.02Digital (computable) send only 3 0.02Dont know 2 0.01Total Responses: 187 20
  • All R esp on ses (C on t.)12. Radiology/ImagingValue Count PercentDigital (computable) send and receive 107 0.58Digital (computable) receive only 41 0.22No digital interaction (uses fax, hard copies, etc.) 20 0.11Digital (computable) send only 12 0.06Dont know 6 0.03Total Responses: 18613. PharmacyValue Count PercentDigital (computable) send and receive 96 0.53Digital (computable) send only 50 0.28No digital interaction (uses fax, hard copies, etc.) 17 0.09Digital (computable) receive only 10 0.06Dont know 8 0.04Total Responses: 18114. Hospitals: for in-patient dataValue Count PercentDigital (computable) receive only 60 0.34No digital interaction (uses fax, hard copies, etc.) 58 0.33Digital (computable) send and receive 47 0.27Dont know 8 0.05Digital (computable) send only 4 0.02Total Responses: 17715. Hospitals: for discharge notesValue Count PercentNo digital interaction (uses fax, hard copies, etc.) 64 0.36Digital (computable) receive only 59 0.33Digital (computable) send and receive 41 0.23Dont know 9 0.05Digital (computable) send only 5 0.03Total Responses: 178 21
  • All R esp on ses (C on t.)16. Do you collaborate with Payors using your EHR in terms of: (check all that apply)Value Count PercentWe do not collaborate with Payors using EHR 83 0.45Excellence of Care incentives (P4P, value based reimbursement,etc) 76 0.42Selected disease management programs 57 0.31Case management for potential "high cost" conditions 25 0.14Member/Patient Satisfaction 14 0.08Other 16 0.16Total Responses: 18317. Has your EHR favorably impacted clinical workflow in the following categories: (check allthat apply)Value Count PercentAcross your delivery system - e.g.. multiple providers and/or multiple sites. 152 0.84Around the individual provider(s) 129 0.72Within the individual clinic(s) - e.g.. among all providers at a single site. 127 0.71Other 18 0.18Total Responses: 18018. Do most of the users in your organization enter data via templates as opposed to relying onnarrative or dictation entries in the "notes" fields?Value Count PercentSome use the templates, some enter narrative in the "notes" fields 103 0.57Most use the templates most of the time 43 0.24Most enter narrative in the "notes" fields 19 0.1All use the templates nearly all of the time 10 0.05Other, N/A 7 0.06Total Responses: 182 22
  • All R esp on ses (C on t.)19. Are you using, do you plan on using the EHR data to support: (check allthat apply) Plan to use Plan to use within 2 within 5 No plans toItem Using today years years use TotalP4P, PQRI, HEDIS and other quality/ incentive programs 110 67 5 1 183Improving clinical coding 111 68 2 3 184Demonstrating clinical cost effectiveness 46 96 17 22 181Individual patient case management 90 80 9 4 183Evidence based predictive modeling 16 88 36 38 178Longitudinal views of patients and populations 49 72 33 27 181Clinical guidelines and/or protocols 92 70 11 8 181Clinical trials or research 68 45 23 43 179Average % 40.1 40.4 9.4 10.1 1,450.0Total Responses: 18620. Are you routinely capturing, or do you plan on capturing the followingdata in digital (computable / structured) data form: (check all that apply) Plan to Plan to Capturing capture capture No plans toItem today within 2 yrs within 5 yrs capture TotalPatient demographics data 182 3 1 186Patient problem, medication, allergies lists (as a part of a structured patient careprogram) 174 11 1 186Clinical notes 161 17 3 4 185Laboratory tests 175 10 185Radiology/Imaging tests 147 32 3 3 185Internal specialist referral reports 132 40 3 8 183External specialist referral reports 71 68 14 29 182Intra-organizational tasking data 88 50 14 27 179Average % 76.8 15.7 2.6 4.9 1,471.0Total Responses: 186 23
  • All R esp on ses (C on t.)21. Are you currently measuring return on investment (ROI) for your EHR system?Value Count PercentNo, we dont formally measure ROI 88 0.51Yes, and the measures are both qualitative and quantitative 37 0.21Yes, and the measures are mainly quantitative 17 0.1Yes, and the measures are mainly qualitative 13 0.08Other 18 0.18Total Responses: 17322. Has your practice experienced any of the following changes in healthcare delivery that can beattributed in part or in full to use of an EHR? (check all that apply)Value Count PercentIntra-office communication is more efficient and/or more reliable (for example, as a result of phone note and worklist features) 146 0.85Physicians have more flexibility because test data and/or charting is available remotely 144 0.84Patient problems are addressed more efficiently during office visits (for example, as a result of a better managedpatient problem list) 125 0.73E-prescribing has contributed to reduced call backs from pharmacies 120 0.7E-prescribing has contributed to avoiding adverse drug events 99 0.58E&M coding is more accurate 98 0.57Chronic disease reminders have contributed to Chronic Disease management 86 0.5Charges are captured more effectively 85 0.49Other 13 0.13Total Responses: 17223. Do you have a process for improving the use/benefits of your EHR?Value Count PercentYes 159 0.9No 9 0.05Not sure 9 0.05Total Responses: 177 24
  • All R esp on ses (C on t.)For the following categories of EMR benefits, please indicate level of expectation in your organization for thefollowing: (check all that apply) 24. Better access to medical records and/or patient data Value Count Percent 5 Expected Highest 120 0.75 4 Expected Hi 32 0.2 3 Expected Med 9 0.06 Total Responses: 161 25. Better access to medical records and/or patient data Value Count Percent 5 Achieved Highest 96 0.56 4 Achieved Hi 48 0.28 3 Achieved Med 22 0.13 1 Achieved Lowest 2 0.01 2 Achieved Low 2 0.01 Total Responses: 170 26. Better access to medical records and/or patient data Value Count Percent 5 Future Highest 121 0.82 4 Future Hi 21 0.14 3 Future Med 5 0.03 Total Responses: 147 27. Better/easier patient follow-up Value Count Percent 5 Expected Highest 76 0.48 4 Expected Hi 51 0.32 3 Expected Med 28 0.18 2 Expected Low 3 0.02 Total Responses: 158 25
  • All R esp on ses (C on t.)28. Better/easier patient follow-upValue Count Percent4 Achieved Hi 59 0.355 Achieved Highest 53 0.323 Achieved Med 44 0.262 Achieved Low 10 0.061 Achieved Lowest 1 0.01Total Responses: 16729. Better/easier patient follow-upValue Count Percent5 Future Highest 99 0.674 Future Hi 37 0.253 Future Med 10 0.072 Future Low 2 0.01Total Responses: 14830. Reduction of medical errorsValue Count Percent5 Expected Highest 71 0.454 Expected Hi 52 0.333 Expected Med 26 0.162 Expected Low 6 0.041 Expected Lowest 3 0.02Total Responses: 15831. Reduction of medical errorsValue Count Percent4 Achieved Hi 61 0.383 Achieved Med 57 0.355 Achieved Highest 31 0.192 Achieved Low 10 0.061 Achieved Lowest 3 0.02Total Responses: 162 26
  • All R esp on ses (C on t.)32. Reduction of medical errorsValue Count Percent5 Future Highest 98 0.644 Future Hi 40 0.263 Future Med 12 0.081 Future Lowest 1 0.012 Future Low 1 0.01Total Responses: 15233. Full "picture" of the clientValue Count Percent5 Expected Highest 75 0.484 Expected Hi 44 0.283 Expected Med 30 0.192 Expected Low 5 0.031 Expected Lowest 2 0.01Total Responses: 15634. Full "picture" of the clientValue Count Percent4 Achieved Hi 62 0.383 Achieved Med 47 0.295 Achieved Highest 37 0.232 Achieved Low 10 0.061 Achieved Lowest 6 0.04Total Responses: 16235. Full "picture" of the clientValue Count Percent5 Future Highest 101 0.674 Future Hi 35 0.233 Future Med 12 0.082 Future Low 2 0.011 Future Lowest 1 0.01Total Responses: 151 27
  • All R esp on ses (C on t.)36. Improved physician-patient communicationValue Count Percent3 Expected Med 49 0.30824 Expected Hi 46 0.28935 Expected Highest 43 0.27042 Expected Low 16 0.10061 Expected Lowest 5 0.0314Total Responses: 15937. Improved physician-patient communicationValue Count Percent3 Achieved Med 75 0.45454 Achieved Hi 40 0.24242 Achieved Low 20 0.12125 Achieved Highest 20 0.12121 Achieved Lowest 10 0.0606Total Responses: 16538. Improved physician-patient communicationValue Count Percent5 Future Highest 71 0.47024 Future Hi 54 0.35763 Future Med 22 0.14571 Future Lowest 2 0.01322 Future Low 2 0.0132Total Responses: 15139. Better ability to plan and execute interventionsValue Count Percent4 Expected Hi 53 0.34643 Expected Med 43 0.2815 Expected Highest 42 0.27452 Expected Low 11 0.07191 Expected Lowest 4 0.0261Total Responses: 153 28
  • All R esp on ses (C on t.)40. Better ability to plan and execute interventionsValue Count Percent3 Achieved Med 73 0.4624 Achieved Hi 43 0.27225 Achieved Highest 17 0.10762 Achieved Low 16 0.10131 Achieved Lowest 9 0.057Total Responses: 15841. Better ability to plan and execute interventionsValue Count Percent5 Future Highest 67 0.44974 Future Hi 55 0.36913 Future Med 23 0.15441 Future Lowest 2 0.01342 Future Low 2 0.0134Total Responses: 14942. Improved coordination of care and referralsValue Count Percent4 Expected Hi 57 0.35635 Expected Highest 52 0.3253 Expected Med 44 0.2752 Expected Low 4 0.0251 Expected Lowest 3 0.0188Total Responses: 16043. Improved coordination of care and referralsValue Count Percent4 Achieved Hi 62 0.3693 Achieved Med 59 0.35125 Achieved Highest 28 0.16672 Achieved Low 13 0.07741 Achieved Lowest 6 0.0357Total Responses: 168 29
  • All R esp on ses (C on t.)44. Improved coordination of care and referralsValue Count Percent5 Future Highest 83 0.5574 Future Hi 49 0.32893 Future Med 14 0.0942 Future Low 2 0.01341 Future Lowest 1 0.0067Total Responses: 14945. Improved case management/ high risk patient managementValue Count Percent4 Expected Hi 58 0.37665 Expected Highest 40 0.25973 Expected Med 33 0.21432 Expected Low 19 0.12341 Expected Lowest 4 0.026Total Responses: 15446. Improved case management/ high risk patient managementValue Count Percent3 Achieved Med 59 0.37584 Achieved Hi 42 0.26752 Achieved Low 33 0.21025 Achieved Highest 13 0.08281 Achieved Lowest 10 0.0637Total Responses: 15747. Improved case management/ high risk patient managementValue Count Percent5 Future Highest 80 0.53334 Future Hi 49 0.32673 Future Med 15 0.12 Future Low 6 0.04Total Responses: 150 30
  • All R esp on ses (C on t.)48. Improved reporting of patient complianceValue Count Percent4 Expected Hi 51 0.32283 Expected Med 40 0.25325 Expected Highest 30 0.18992 Expected Low 25 0.15821 Expected Lowest 12 0.0759Total Responses: 15849. Improved reporting of patient complianceValue Count Percent3 Achieved Med 59 0.36882 Achieved Low 40 0.254 Achieved Hi 34 0.21251 Achieved Lowest 20 0.1255 Achieved Highest 7 0.0438Total Responses: 16050. Improved reporting of patient complianceValue Count Percent5 Future Highest 56 0.3664 Future Hi 48 0.31373 Future Med 32 0.20922 Future Low 14 0.09151 Future Lowest 3 0.0196Total Responses: 15351. Improved use of guidelines/protocols by providersValue Count Percent4 Expected Hi 48 0.30975 Expected Highest 45 0.29033 Expected Med 43 0.27742 Expected Low 11 0.0711 Expected Lowest 8 0.0516Total Responses: 155 31
  • All R esp on ses (C on t.)52. Improved use of guidelines/protocols by providersValue Count Percent3 Achieved Med 58 0.37664 Achieved Hi 44 0.28572 Achieved Low 29 0.18831 Achieved Lowest 13 0.08445 Achieved Highest 10 0.0649Total Responses: 15453. Improved use of guidelines/protocols by providersValue Count Percent5 Future Highest 84 0.5494 Future Hi 47 0.30723 Future Med 20 0.13071 Future Lowest 2 0.0131Total Responses: 15354. Demonstrated clinical cost effectivenessValue Count Percent4 Expected Hi 48 0.30383 Expected Med 46 0.29115 Expected Highest 38 0.24052 Expected Low 19 0.12031 Expected Lowest 7 0.0443Total Responses: 15855. Demonstrated clinical cost effectivenessValue Count Percent3 Achieved Med 58 0.36944 Achieved Hi 39 0.24842 Achieved Low 36 0.22931 Achieved Lowest 16 0.10195 Achieved Highest 8 0.051Total Responses: 157 32
  • All R esp on ses (C on t.)56. Demonstrated clinical cost effectivenessValue Count Percent5 Future Highest 66 0.43424 Future Hi 49 0.32243 Future Med 30 0.19742 Future Low 6 0.03951 Future Lowest 1 0.0066Total Responses: 15257. Are you currently addressing or do you have a plan to address the following?Item Yes No TotalEstablishing common policies, definitions andguidelines to reduce variation of practice 159 20 179Managing information overload at the physician level 135 42 177Redesigning the roles of physicians around EHRcapabilities 145 34 179Redesigning the roles of mid-levels around EHRcapabilities 142 37 179Redesigning the roles of clinical support around EHRcapabilities 166 11 177Average % 83.8 16.2 891Total Responses: 180 33
  • All R esp on ses (C on t.)58. How critical is your EHR to meeting your organizational goals for: Critically Low NotItem important Important Neutral importance Not important applicable TotalClinical quality 131 39 4 7 181Patient service 91 72 10 4 4 181Operational efficiency 110 52 12 3 3 180Risk or incentive revenue 70 71 27 6 5 1 180Market position 72 76 22 5 4 1 180Average % 52.5 34.4 8.3 2 2.5 0.2 902Total Responses: 18159. Which of the following do you consider your most significant hurdles to implementing an EHR in the future? Significant Somewhat of NotItem Huge hurdle hurdle a hurdle Minor bump Not an issue applicable TotalBoard / leadership commitment 2 3 5 6 17 1 34Physician resistance 2 5 15 7 5 34Concerns about interoperability withother provider systems 3 9 13 6 3 34Concerns about the value an EHRcan really deliver 4 6 11 5 8 34Cost/Investment 13 12 4 4 1 34Other 2 1 5 8Average % 14.6 20.2 27 15.7 19.1 3.4 178Total Responses: 34 34
  • ForM or I f m ation e n orAmerican Medical Group Association1422 Duke StreetAlexandria, VA 22314-3403(703) 838-0033 / (703) 548-1890 faxwww.amga.orgJHD Group5055 Keller Springs Road, Ste. 240Addison, TX 75001(972) 220-0474www.jhdgroup.com 35