Health IT

EHR adoption reaches “tipping point” but challenges remain

half full or half emptyThe Department of Health and Human Services marked a milestone this week, announcing more than 50 percent of eligible providers have adopted or used electronic health records — a goal for 2013. But even as providers ramp up their systems to satisfy Meaningful Use requirements, they face several challenges.

“We have reached a tipping point in adoption of electronic health records,” said Secretary Kathleen Sebelius in a statement.

About 191,305 Medicare eligible professionals — a group that’s dominated by physicians but also includes dentists, optometrists, podiatrists and chiropractors — have received $3.7 billion in Medicare incentive payments for meeting Meaningful Use requirements since 2011, according to a Department of Health and Human Services report.. More than 88,903 Medicaid-eligible professionals for received  nearly $2 billion. About 3,880 hospitals to date have received $8.7 billion through Medicaid only, Medicare only and a combination of Medicare and Medicaid programs.

To demonstrate the first stage of Meaningful Use, eligible professionals had to order prescriptions electronically, send appointment reminders to patients for preventive or follow up care, and display lab results in the EHR. One of the key things hospitals must provide to comply with Meaningful Use Stage 2 is a discharge summary that includes, among other things: admit and discharge date and location; reason for hospitalization; care team including the attending of record as well as other providers of care; procedures performed during admission; current and past problem list; summary of care record for transitions of care or referrals to another provider.


Some challenges to providers expanding electronic medical records across their systems include the variety of systems that differ from one practice to another. And the standardization issue isn’t confined to providers. Last month, the ONC marked a different milestone of sorts when it withdrew EHR certification for health IT vendor EHRMagic for two electronic health record systems that failed to demonstrate meaningful use. It came as a surprise when ONC officials concluded that surveillance activities varied across its authorized certification bodies, highlighting a need for consistency. It also sparked debate about what the consequences would be for any providers that used a system that loses certification.

The way that providers implement new systems and upgrades is also a critical factor. There are trails of medical errors caused by rapid implementation or inadequate training for staff — an issue the Pennsylvania Patient Safety Authority has highlighted.


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