While physician practices are beginning to adopt electronic health records systems and join health information exchanges, they may be doing so at a slower pace than what the federal government would like, according to a new survey.
The Physicians Practice 2012 Technology Survey, released July 17, included 1,356 practices. Out of those practices, a majority of independent practices – 54 percent – said they have adopted an EHR. Of the practices that have put systems in place – including both independent practices and those part of hospital or integrated care delivery systems – 57.6 percent said that their implementation is complete and that the system is being used.
The most common reason practices have not yet purchased an EHR system is because of cost. About 29 percent of respondents said they don’t yet have an EHR because they too expensive.
Terri Ripley, director of systems and programming, at Centra Health, a nonprofit healthcare system based in Lynchburg, Va., agreed that cost is a major barrier for some providers, especially small physician practices and rural hospitals. But something else may be at play.
“I think the biggest barrier is changing the workflow of physicians and nurses,” Ripley says.
In fact, 14 percent of practices that responded to the Physicians Practice survey said they have not yet purchased EHRs because “some physicians just don’t want to change the way they practice.”
But that attitude has not stopped Centra Health from getting more connected. The system, which includes three hospitals in Central Virginia and a medical staff of 490, has been recognized twice as one of the “Most Wired” hospitals in the country for delivering excellent patient care by Hospitals & Health Networks magazine.
Ripley, who heads up the system’s meaningful use initiatives, oversaw Centra’s system upgrade that began in December 2010. The system became one of the first in the nation to achieve meaningful use in 2011 for its hospitals and 60 eligible providers.
Through the MedVirginia health information exchange, or HIE, Centra is able to share test results and other medical information among hospitals and participating physicians.
“We had been faxing these reports all along, and now we have electronic interfaces to share reports and patient information,” Ripley says.
That has cut down on the time it takes to transfer patient information, boosting efficiency through Centra’s hospitals and provider network.
According to the Physicians Practice survey, 66 percent of respondents also noted that EHRs have made their workflow more efficient overall.
A Closer Look: How It Works
Through Centra’s system, doctors have a web portal where they can sign in, and patients can request either a paper or electronic version of their medical records. Centra is also using electronic alerts within its EHR system to notify doctors of important patient information or medical history, such as if a patient has diabetes.
Ripley says HIEs can help smooth transitions of care and improve care coordination because providers could have access to a patient’s medical records before the patient arrives in a particular healthcare setting, such as when a patient goes from a primary care doctor to a specialist. Emergency departments would also benefit from HIEs if they could access a patient’s medical records almost instantly.
But despite the benefits of HIEs, Centra is still among the minority that has joined an exchange.
According to the Physicians Practice survey results, a majority of 2012 respondents are independent physicians' practices and are staying self-reliant when it comes to health IT by not joining up with an HIE, which enables them to share data across other healthcare systems. Nearly 67 percent of respondents said their practice is not part of a health information exchange, while 33.5 percent said they are part of an HIE.
Despite widespread hesitation to adopt EHRs and participate in HIEs because of security and privacy concerns, Ripley remains optimistic.
“Some people are concerned with the security, but paper was not secure either,” she says.
Ripley says that once universal standards are set for HIEs and hospitals and independent physician practices are able to share information with one another, there is likely to be a bigger uptick in HIE participation.