Thursday, April 7, 2011

MGMA study of EHRs shows optimization, meaningful use eligibility a challenge

ENGLEWOOD, Colo., April. 6, 2011— The Medical Group Management Association (MGMA) today released new findings from its Electronic Health Records: Status, Needs and Lessons 2011 Report Based on 2010 Data, which provides a snapshot of medical practices’ experiences adopting an electronic health record (EHR) system and the barriers to those that have not.

While most (80.1 percent) medical practices that have already adopted an EHR said they intend to participate in the EHR meaningful use incentives available through the HITECH act, only 13.6 percent of them indicated that they are currently able to meet all 15 core criteria for eligibility to receive incentive payments. Interest in qualifying for EHR incentives was also high among the respondents who are currently using paper medical records, with 28.8 percent indicating that they were in the process of selecting an EHR system. Within this segment, three-fourths (75.2 percent) said they also planned to participate in the HITECH incentive program.

Satisfaction with EHRs
Most EHR owners (nearly 72 percent) said they are satisfied with their overall system. All EHR owners were split, however, over the ability for their EHRs to increase physician productivity, with 26.5 percent reporting that productivity had increased, 30.6 percent indicating that it had decreased, and 42.9 percent reporting that there was no change in productivity after implementation.

When MGMA examined the 20.7 percent of EHR users who said that they had optimized their EHR since implementation, 41.1 percent reported that productivity had increased, 16.5 percent indicated that productivity had decreased, and 42.4 percent reported that there was no change in productivity.

More than one in three (38.4 percent) of all EHR users said total practice operating costs increased following EHR implementation, while 25.9 percent said costs decreased and 35.7 percent reported no change in cost.

Once again, when MGMA examined only those who said that they have optimized their EHR since implementation, 26.8 percent said total practice operating costs had increased, while 39.7 percent said costs had decreased and 33.5 percent reported no change in costs.

Barriers to EHR adoption/optimization
Of practices still using paper records, more than 78 percent feared there would be a "significant" to "very significant" loss of provider productivity during implementation, and two-thirds (67.4 percent) had similar concerns about the loss of physician productivity after the EHR transition period. The practices currently using paper medical records described the other significant to very significant barriers to EHR adoption as “insufficient capital resources to invest in an EHR” (71.7 percent) and “insufficient expected return on investment” (56.9 percent).

"The EHR incentive program seeks to address implementation costs, a critical barrier to medical groups' adoption of EHRs. While the majority of groups plan to have their eligible professionals participate in the program, including those organizations that have not yet implemented an EHR, it is clear that groups face significant system optimization challenges,” said MGMA President and CEO William F. Jessee, M.D., FACMPE. “We are hopeful that as the future stages of the incentive program are developed, the government will take into account the difficulties medical groups currently face in meeting the meaningful use requirements.”

Practice ownership influenced EHR implementation and optimization. Interestingly, independent medical practices were more likely to have a fully implemented and optimized EHR than their peers owned by hospital systems.

“Hospital-based practices have access to information resources of their parent health system, which would normally imply that these practices would be further along toward optimization,” said MGMA Innovation and Research Vice President David Gans, MSHA, FACMPE, who directed the research. “However, integrated systems are much more complex environments than independent physician practices and their information systems often have to encompass both in-patient and physician components. The added complexity, combined with the geographic dispersion of most hospital-based physician practices, has hindered the advancement. In addition to redesigning how patient care is delivered, practices must redesign workflow, more fully utilize the system’s capabilities, integrate the EHR and practice management systems, and fully coordinate system interoperability with systems used by hospitals, reference laboratories, imaging facilities, pharmacies, insurers, etc., to realize the benefits of an EHR. These activities are much more difficult to achieve in hospital systems.”

One of the hurdles in optimizing any new technology is adequately training new users. More than half – 53.2 percent of respondents – said that they either "mildly" or "severely" under-allocated the training time needed during the implementation of their EHR systems.

MGMA’s study also examines EHR integration with the practice management system, tracks user satisfaction with this integration, and explores user experience with various EHR functionalities.

This report examines 4,588 valid online responses that came from a wide variety of healthcare organizations, including medical group practices representing about 120,000 physicians. The research was funded by PNC Bank.

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