Physicians aren’t connecting much to one another’s EHRs
■ A report says few doctors are exchanging patient information electronically in any meaningful way, despite believing it’s important to have that capability.
Even though physicians have adopted electronic health records at a rapid pace during the last few years, few are “meaningfully” connected in a way that would allow them to share information from their EHRs with hospitals, payers and other physicians, according to a new report. However, doctors and others say getting connected — soon — is necessary for success under new practice and pay models.
According to a survey and report released in June by the ratings service Black Book Rankings, 97% of physicians and 80% of hospitals are “meaningfully unconnected,” which means they are not exchanging information regularly through a sustainable health information exchange. That is defined as an HIE of sufficient geographic scope that allows access to hundreds of physicians and hundreds of thousands of patient records, and allows other functions such as electronic prescribing and lab result access.
Black Book Rankings interviewed about 4,000 health care delivery and insurance organization leaders for a report meant to rate the best health information exchange vendors. The report did not specify how many physicians were interviewed.
HIEs, regional networks that connect physicians, hospitals and insurers, are considered the underpinning of a national health information network. They are funded initially with public money and grants but are expected to be supported privately by their users once they are up and running. However, in many cases, the networks can’t sustain themselves after the public money and grants run out. Black Book Rankings noted that one in five of operating HIEs merged or ceased operations in 2011.
The struggle comes even though 94% of those surveyed said private, community-based HIEs are “the preferred choice” to ensure success under such models as accountable care organizations, in which practices can get bonuses for improving patients’ health while cutting costs. Meaningful use incentives from the federal government are meant to ensure that physicians have the capability of sharing information, although that doesn’t necessarily mean they actually are doing so.
“The uncertain sustainability of private HIEs has caused some health care organizations to delay the implementation of HIE infrastructure, despite the strategic importance to ACO development,” the report said.
The report pointed out that the acknowledgement of a need for strong HIEs, as well as physicians’ escalating rate of installing EHRs, should get more doctors connected.
According to Black Book Rankings, 67% of all primary care physicians surveyed had a “basic EHR,” which under the federal government’s definition means it includes patient history and demographics; a problem or diagnosis list; physician notes; medications; allergies; electronic prescribing; and the ability to view laboratory and imaging results electronically. That is up from 15% in 2008.
Breaking down physician demographics by practice size, urban or rural setting, and region of the United States, the only group in which more than 25% of doctors had no EHR at all was rural physicians, 69% of whom do not have such systems.