E-prescribing sign-up highest among small practices
■ The nation’s largest e-prescribing network finds solo practices experienced the highest growth in adoption.
Government incentives aimed at e-prescribing and electronic health record use had the intended effect, as they are considered the primary reasons for the great interest in e-prescribing among small practices.
The 2011 “National Progress Report on e-Prescribing and Interoperable Health Care” by Surescripts, the largest e-prescribing network, found that 58% of office-based physicians are using e-prescribing systems and the highest use — and largest growth — has been among small practices. Solo practices saw the most significant growth from 2010 to 2011.
When broken down by practice size, the report found that practices with six to 10 physicians have the highest adoption rate at 55%, up from 44% in 2010, followed by two- to five-physician practices, whose adoption rate of 53% was up from 42% in 2010. From 2010 to 2011, e-prescribing in solo practices rose from 31% to 46%.
Among larger practices, those with 11 to 25 physicians saw their rate increase from 34% to 46%; those with 25 to 100 went from 31% to 35%, and practices with 100 or more increased from 22% to 27%.
Seth Joseph, director of strategy and innovation for Surescripts, said there is no question incentive programs have had a tremendous effect on e-prescribing adoption and use trends.
In 2009, the Medicare Improvements for Patients and Providers Act of 2008 began an incentive program aimed at promoting e-prescribing. Physicians who successfully prescribed electronically under Part D earned a 2% bonus in 2009. The bonuses phased down to 1% in 2011 and will go down to 0.5% in 2013. But in early 2012, doctors eligible to prescribe electronically who hadn’t started using the technology were subject to penalties.
In addition, the Medicare and Medicaid meaningful use incentive program includes e-prescribing requirements. In 2011, those programs started paying incentives that could accumulate to $44,000 per physician over five years under Medicare and $63,750 over six years under Medicaid for the meaningful use of electronic health record systems. The incentives are scheduled to turn to penalties in 2015.
The Surescripts report found that about 60% of physicians who started e-prescribing in 2008 met the stage 1 e-prescribing measures, and 38% of this group would meet the proposed stage 2 measures.
Joseph said Surescripts recently finished a report that compared incentives to penalties to see which was more effective in spurring adoption. The paper is awaiting publication in a peer-reviewed journal, so he couldn’t discuss specific findings. But, he said, both have certainly proved to be effective.
When Surescripts started doing progress reports in 2008, Joseph said most small practices adopted stand-alone e-prescribing systems because they were much cheaper. Now, he said, the majority are using e-prescribing functions built in to robust, integrated EHR systems. The report found that 82% of e-prescribing physicians use an EHR to prescribe.
The adoption trends reported by Surescripts are similar to those reported by market research firm SK&A in March regarding faster growth in EHR use among smaller practices. SK&A found that EHR adoption rates for single-doctor offices jumped from 30.8% to 36.9% in the second half of 2011. SK&A also credited the incentive programs for the increase.