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EHR adoption outpaces HIE, patient engagement


Physicians are finding barriers to electronic information exchange difficult to overcome.

Physicians, especially those in office-based practices, are adopting electronic health records (EHRs) more readily than they are exchanging health information with other providers or engaging with their patients electronically.

Those findings emerge from a new survey looking at the results of the 2009 legislation designed to encourage adoption of EHRs and health information exchange (HIE), the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Using data from the National Ambulatory Medical Care Survey and the 2009-13 Electronic Health Records survey, the study’s authors found that 48% of office-based physicians had adopted at least a basic EHR system by 2013, a doubling of the rate since 2009 and a 22% increase since 2012. When practices with more sophisticated EHR systems are included, the adoption rate among office-based physicians increased to 78%. Primary care physicians led specialists in EHR adoption by a margin of 53% to 43%.

Read: Physician outcry on EHR functionality, cost will shake the health information technology sector.

However, only 39% of office-based physicians reported having any form of electronic HIE with other ambulatory providers or hospitals in 2013. And while just over 50% of physicians could exchange secure electronic messages with patients, only about half of those actually did so. Similarly, about half of the practices able to provide patients the ability to view, download, or transmit information from their medical records actually did so.

The findings jibe with recent announcements that physicians and healthcare institutions are having difficulty qualifying for the second stage of the meaningful use incentive program (MU2), since doing so requires attesting to both HIE and patient engagement. Halfway through 2014, only 972 eligible providers and 10 hospitals had successfully attested to MU2 according to the federal Health Information Technology Policy Committee.

 Perhaps not surprisingly given the disparity in resources, physicians working in large, multispecialty practices-especially those owned by a hospital or other large healthcare organization-had higher rates of EHR adoption and were more likely to engage in HIE and use their EHRs’ capabilities to electronically communicate with patients. Overall, “physicians in primary care specialties, multi-specialty practices, or the Midwest and significantly higher rates of EHR adoption, compared with physicians in other specialties, single-specialty practices, or the Northeast,” the survey found.

Read: Smart planning helps practice succeed with EHR

 As to why physicians aren’t sharing more patient data electronically with other healthcare providers, the researchers cite privacy concerns and technical barriers. “Limited interoperability of EHR systems across vendor platforms can hinder HIE, even among providers in the same organization,” they note. “Additionally, HIE often requires the redesign of clinical work flow, which is inherently disruptive and may be difficult to justify in the absence of a clear business case for HIE.”



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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health