Survey Names EHRs Most Likely to Help Physicians Earn Bonus

April 13, 2011

April 13, 2011 — Clinicians with electronic health record (EHR) systems from Epic Systems and Greenway Medical Technologies may be best prepared to qualify for federal incentive payments for using the technology in a "meaningful" way, according to KLAS, a firm that researches medical software and services.

The 2 products also were customer favorites in a KLAS ranking of EHRs for medical practices published in December. Greenway's software took top honors among medical practices of 6 to 25 physicians, while the Epic program was number one among groups with more than 100 physicians.

The economic stimulus legislation of 2009 — known as the American Recovery and Reinvestment Act — authorized up to $44,000 under Medicare and almost $64,000 under Medicaid to physicians who demonstrate "meaningful use" of an EHR system as defined by the US Department of Health and Human Services. In so many words, meaningful use amounts to improving and streamlining patient care with the digital technology.

To qualify for the incentive cash, clinicians must satisfy 15 meaningful-use criteria considered "core" along with any 5 from a menu of 10 additional criteria. They can begin to report, or attest, to CMS on Monday, April 18, that they are meeting the requirements this year, the first year for the incentives to be paid out. For more information on registering for the incentive program and how to attest to meaningful use, visit the CMS Web site.

Many Providers Naively Optimistic About Receiving Bonus

KLAS surveyed 597 healthcare providers about 8 areas of EHR meaningful use, some of which include more than 1 criterion:

  • Using computerized provider order entry for medication;

  • Transmitting prescriptions electronically;

  • Implementing drug-drug and drug-allergy alerts;

  • Giving patients electronic access to their health information;

  • Reporting clinical quality measures to CMS or state Medicaid programs (an example of data mining);

  • Maintaining active medication, problem, and medication-allergy lists;

  • Charting progress notes; and

  • Implementing 1 clinical decision-support rule — in other words, a clinical alert — and tracking compliance to it (an example of a clinical alert might be a reminder to order an eye exam each year for a patient with diabetes; drug-drug and drug-allergy alerts do not count for this requirement)

According to KLAS, 80% of respondents say they are confident that they will satisfy meaningful-use requirements by year's end. However, KLAS states that this optimism is largely naive because most respondents are struggling to make the grade in 2 areas. Less than 35% are giving patients electronic access to their health information, and only about half have implemented a clinical alert. On a scale of 1 to 9, respondents scored the ability of their EHRs to provide these functions at 6.7.

KLAS notes that although EHRs must be certified by testing organizations as capable of meeting meaningful-use requirements, "not every vendor is successful in delivering those capabilities to their customers."

Epic EHR users reported the deepest adoption of all key meaningful-use functions, and its system scored highest in giving patients digital access to their record, thanks to the success of the company's patient portal, called MyChart. Greenway customers — 96% of them — are the most confident about receiving a bonus in 2011, and they are heavily implementing most of the meaningful-use functions of their software.

KLAS calls Epic and Greenway the "safest bests" for meaningful-use success. The riskiest bets for EHRs, according to KLAS, are from 3 vendors: Praxis, SRSsoft, and simplifyMD.

The KLAS report is available for purchase on the company's Web site. The price for physicians is $980. Physicians can look up survey data on individual vendors free of charge if they first complete an online questionnaire about the medical software, equipment, or computer services used in their practices.

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