Not-so-rosy numbers

Last week, Dr. David Blumenthal announced the results of two surveys funded by the Office of the National Coordinator for Health Information Technology on hospital and physician participation in the federal electronic health-record incentive programs.

But Dr. B left out a few numbers in going over the results of the survey of office-based physicians conducted by the National Center for Health Statistics. On request, the ONC and NCHS released those missing numbers.

Docs were asked: "Are there plans to apply for Medicare or Medicaid incentive payments for meaningful use of health IT?" Blumenthal reported on their answers in part, noting that 41.1% indicated "yes" and 14% said "no." However, a 44.9% plurality, which he did not mention, chose "uncertain whether we will apply."

Those who answered "yes" were asked a follow-up question: "What year do you expect to apply for the meaningful-use payments?" Of the 41.1% of docs who indicated they were sure they would apply (a figure Blumenthal released), nearly one in five (19.7%, a number he didn't mention) were unsure as to when.

Additionally, the NCHS asked physicians, "Which incentive payment do you plan to apply for?" Their responses to this question also weren't mentioned by Blumenthal last week. Not surprisingly, given current eligibility thresholds, 65.1% selected Medicare and just 6.8% chose Medicaid, but again there was considerable uncertainty, with 28.2% choosing "unknown" or leaving the choice blank.

Predicting the future is always a dicey proposition. That variability was heightened for any questions on possible physician participation in the federal EHR incentive program because the broader National Ambulatory Medical Care Survey of which these questions were a part was conducted between April and July 2010. Because the final meaningful-use criteria weren't released until mid-July last year, it's likely that most of the survey participants shot off their opinions before they even had a fixed set of targets at which to aim.

We'll have updated numbers on the first two questions focused on intent and timing to participate in the EHR incentive program when the 2011 NCHS survey is completed. The third question about which incentive program physicians will sign up for—Medicare or Medicaid—will be dropped from the questionnaire this year.

What the current numbers suggest is that providers' uncertainty means ONC has a lot of physician education and persuasion yet to do.



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