Solo and Small Practices Increase EHR Adoption, Survey Finds

Mark Crane

March 26, 2014

Physician office usage of electronic health records (EHRs) rose more than 10 percentage points in solo and small group practices, and implementation continues to grow for all physicians, a new study shows.

Results of a telephone survey of more than 270,000 US medical sites reveal that the EHR adoption rate for single-physician offices grew 11.4% to 53.7%, up from 42.3% the prior year, SK&A, a healthcare information research firm that tracks adoption rates for the government, said in its annual report.

The adoption rate for offices with 26 or more physicians increased only 1.6%, to 77.5%. Overall, the rate of EHR adoption grew from 50.3% to 61% compared with the previous year, the report noted.

"What has accelerated the adoption of [EHRs] among smaller practices is the availability of more than 450 different solutions to fit their practice needs, size and budget," Jack Schember, senior director of marketing for SK&A, said in a press release. "The healthcare [information technology] community responded well to the opportunity presented by the EHR adoption incentives offered through the American Recovery and Reinvestment Act by providing a variety of options to physicians with relatively easy implementation and training support. Physicians also realize they have a limited window of opportunity to take advantage of federal reimbursements by showing 'meaningful use' of digital record-keeping technology."

The SK&A survey is in line with other recent reports. "This survey confirms what we are hearing and reading from other sources. The federal meaningful use program has succeeded," Peter Basch, MD, medical director of ambulatory EHR and health information technology policy at MedStar Health in Columbia, Maryland, and chair of the medical informatics committee of the American College of Physicians, told Medscape Medical News.

"If one looks at the incentive dollars distributed thus far, the program is successful beyond all expectations," he said. "As this survey highlights, it's also very successful in the solo and small practice segments. There had been considerable policy concern in 2008 and 2009 that a federal incentive program for EHR adoption could be the force that 'killed' solo and small practices, as only large practices and enterprises had the resources to purchase, adopt, and implement EHRs."

"Adoption is just the beginning," Dr. Basch said. "The meaningful use program...creates an infrastructure that prepares doctors and other providers for healthcare delivery where information flows securely and far more freely than before, and with a focus on improving outcomes. How our country will take advantage of this growing health [information technology] infrastructure is yet to be determined."

The report also found that

  • Physician specialties with the highest adoption rates are dialysis (80.6%), internal medicine/pediatrics (75.8%), nephrology (70.5%), pathology (69.4%), and radiology (69.2%).

  • The top 5 states for EHR adoption are Utah (71.6%), South Dakota (71.2%), Wyoming (71.0%), Iowa (70.8%), and North Dakota (69.2%).

  • EHR adoption among integrated health systems had the highest rate of all site ownerships. The percentage jumped to 71.4%, up from 63.4% a year ago.

  • EHR adoption rises as the number of physicians practicing at each site rises. Offices with 3 to 5 practicing physicians had 69.6% adoption, whereas offices with 11 to 25 practicing physicians had 78.1% adoption.

  • EHR adoption rises as the number of exam rooms at each site rises. Offices with 1 exam room had 39.7% adoption rates, whereas offices with 11-plus exam rooms had 74.8% adoption rates).

  • Offices with average daily patient volumes of 1 to 50 patients had 57.5% adoption, and offices with 101-plus patients had 76.3% adoption

The report also tracks EHR vendor market share; the top 3 vendors are Epic Systems Corp, eClinicalworks, and Allscripts.

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