EHR adoption rates jump for solo practices

For the first time, medical practices with one or two physicians are the fastest-growing segment for adoption of electronic health records.

An ongoing study by SK&A, a marketing research firm in Irvine, Calif., found that for the second half of 2011, adoption rates for single-doctor offices jumped from 30.8% to 36.9%. This is the first time that growth in that segment outpaced that of large practices.

“Typically, it’s been the larger practices that have led the bunch, because they’ve had the most support and the most wherewithal, so this growth really is significant,” said Jack Schember, director of marketing for SK&A, whose company has been tracking EHR adoption trends for three years by continuously surveying 240,281 U.S. medical practices.

Schember said meaningful use incentives and all of the resources the federal government has made available to help small practices achieve them, such as funding regional extension centers, have played a large role in the increase in adoption.

The Health Information Technology for Economic and Clinical Health Act, a provision of the 2009 economic stimulus package, allows practices to earn up to $44,000 per physician over five years from Medicare or nearly $64,000 over six years from Medicaid if they show meaningful use of EHRs.

“The physicians are realizing through meaningful use there is reimbursement and there is light at the end of the tunnel for them, particularly with the smaller practices,” Schember said. “Because they are one- and two-doctor practices, this money means a lot to them.”

The growth rate for EHR adoption in large practices has slowed down, he noted, partially because they are beginning to hit a ceiling. Adoption in practices of 26 or more physicians grew from 75.5% to 77.2% in 2011. “But I wouldn’t say that that’s the end for the large practices,” Schember said. There are many that are upgrading old systems and changing vendors.

Although adoption rates for small practices have long lagged behind those of large groups, the market size for small practices is considerably larger.

Solo practices account for 55% of the medical sites in the U.S., according to SK&A, and practices of 20 or more physicians account for only 1%. Overall, physician practices saw an increase in EHR adoption from 40.4% in July 2011 to 45.6% in January.

“[V]endors of EHR technology and their partners are continuing to promote aggressively to the small-office market, which they see as the new frontier of sales opportunities,” said Dave Escalante, vice president and general manager of SK&A and OneKey, both subsidiaries of Cegedim, a global technology and service company that specializes in health care.

SK&A is under contract to provide adoption data to the Office of the National Coordinator for Health Information Technology, which is overseeing the meaningful use incentive program.