Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

Patel, Vaishali; Jamoom, Eric; Hsiao, Chun-Ju; Furukawa, Michael F.; Buntin, Melinda Beeuwkes

doi:10.1007/s11606-012-2324-x

Cited by 64 publications

(50 citation statements)

References 27 publications

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“…7,[9][10][11] Other studies 12-15 of ambulatory clinics showed that practices with 11 or more physicians were more likely to use an EMR system compared with smaller ones. Surgical specialty offices, such as otolaryngology, affiliated with institutions (eg, health maintenance organizations or academic centers) are more likely to use EMRs.…”

Section: Discussionmentioning

confidence: 99%

Association Between Electronic Medical Record Implementation and Otolaryngologist Productivity in the Ambulatory Setting

Haidar

Moshtaghi

Mahboubi

et al. 2017

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEIn the current health care era, many medical practices are transitioning to a new electronic health record system. Until now, there has been little information published on the association between electronic medical record (EMR) use and otolaryngologist productivity in the ambulatory setting.OBJECTIVE To examine the association between transitioning to an EMR system and physician productivity in otolaryngology. DESIGN, SETTING, AND PARTICIPANTSObservational study at a tertiary care academic ambulatory center. Participants were 5 full-time otolaryngologists in practice, among whom a retrospective analysis of physician productivity was performed from May 5, 2013, through April 30, 2015. MAIN OUTCOMES AND MEASURESWe examined 5 practicing otolaryngologists for 24 months (12 months before and 12 months after transitioning to a new EMR system). Physician productivity was measured using the mean work relative value units (wRVUs) and the mean number of clinic visits. Each practitioner, with his wRVUs and clinic visit volume, was compared before and after implementation of the EMR system. The overall change in wRVUs and clinic visit volume was measured. The mean time spent after a full clinic day editing documentation before and after implementation of the EMR system for each practitioner was also recorded.RESULTS Among all 5 practitioners (age range, 38-51 years), the monthly wRVUs decreased from a mean of 334 before EMR implementation to a mean of 284 after EMR implementation, with an absolute difference of 50 (95% CI, 6-85). The monthly clinic visit volume decreased from a mean of 132 to 121, with an absolute difference of 11 (95% CI, 0-18). When examined individually, only 1 physician had a significant decrease in wRVUs. The remainder of the physicians did not demonstrate a significant change in wRVUs or clinic visit volume. On average, the physicians spent 2.1 hours after clinic reviewing and editing documentation before the transition to the EMR system and 1.9 hours after the transition. CONCLUSIONS AND RELEVANCETransitioning to an EMR system in an ambulatory otolaryngology tertiary care setting slightly decreased physician productivity as measured by wRVUs and clinic visit volume in the 12-month period after implementation in an incentivized compensation system.

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Section: Discussionmentioning

confidence: 99%

Association Between Electronic Medical Record Implementation and Otolaryngologist Productivity in the Ambulatory Setting

Haidar

Moshtaghi

Mahboubi

et al. 2017

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

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“…1 Beginning with 2007 we also analyzed adoption of EHR systems that had certain basic functions, including the ability to record information on patient demographics; compile problem lists; document medications; store clinical notes; view laboratory and imaging results; and execute computerized prescription ordering. Tracking these functions provided a better measure of whether physicians had EHR systems with features consistent-at least in part-with meaningful-use requirements 3,[5][6][7] of the Office of the National Coordinator for Health Information Technology.…”

Section: Study Data and Methodsmentioning

confidence: 99%

Physicians In Nonprimary Care And Small Practices And Those Age 55 And Older Lag In Adopting Electronic Health Record Systems

2012

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By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care. We found that although trends in adoption of electronic health record systems across geographic regions converged from 2002 through 2011, adoption continued to lag for non-primary care specialists, physicians age fifty-five and older, and physicians in small (1-2 providers) and physician-owned practices. Federal policies are specifically aimed at encouraging primary care providers and small practices to achieve widespread use of electronic health records. To achieve their nationwide adoption, federal policies may also have to focus on encouraging adoption among non-primary care specialists, as well as addressing persistent gaps in the use of electronic record systems by practice size, physician age, and ownership status.

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“…Because adoption of innovative programs and tools can vary with practice characteristics such as specialty, size, and organizational structure, [17][18][19][20] …”

Section: Practice Characteristicsmentioning

confidence: 99%

Point-of-Care Child Psychiatry Expertise: The Massachusetts Child Psychiatry Access Project

Cleave

Perrin

2015

Pediatrics

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OBJECTIVE: Since 2005, after a pilot program, the Massachusetts Child Psychiatry Access Project (MCPAP) has provided point-of-care psychiatry expertise and referral assistance by telephone to primary care providers. We examined its adoption and use and the practice characteristics associated with different adoption timelines and use patterns. METHODS:We merged data on calls to MCPAP in 2005 to 2011 with practice data (enrollment year, panel size, regional team assignment). We categorized practices' days from enrollment to first call (adoption) (0-100, 101-365, .365 days) and quartile of call frequency (use) (annual highest, middle, and lowest quartiles of number of calls per 1000 empanelled patients). We determined associations between adoption and use and practice characteristics using multivariate models. CONCLUSIONS: Adoption and use of MCPAP varied widely. Timing of enrollment, assignment to the team from the program's pilot site, and panel size were associated with patterns of adoption and use. Findings may help other programs design effective implementation strategies. WHAT'S KNOWN ON THIS SUBJECT:A program to support pediatric primary care providers in mental health care using point-of-care, telephone-based advice from specialists has been available since 2005 in Massachusetts. Other US states are implementing similar models. Little is known about how providers use this service. WHAT THIS STUDY ADDS:There is wide variability in adoption and use of this program. Patterns are associated with panel size, enrollment timing, and assignment to the program team at the pilot site. Findings will help new programs establish expectations and design implementation interventions.

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Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

Cited by 64 publications

References 27 publications

Association Between Electronic Medical Record Implementation and Otolaryngologist Productivity in the Ambulatory Setting

Association Between Electronic Medical Record Implementation and Otolaryngologist Productivity in the Ambulatory Setting

Physicians In Nonprimary Care And Small Practices And Those Age 55 And Older Lag In Adopting Electronic Health Record Systems

Point-of-Care Child Psychiatry Expertise: The Massachusetts Child Psychiatry Access Project

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