The share of hospitals with either a basic or a comprehensive EHR was 11.9% in 2009, but only 2% reported having EHR systems that would allow them to meet the federal government's meaningful-use criteria, according to research published in August in the policy journal Health Affairs.
The researchers, headed by Ashish Jha, a physician and an associate professor of health policy and management at Harvard School of Public Health, also found a widening IT divide opening between the digital haves and have-nots in this country.
Meanwhile, a little more than half of office-based physicians in direct patient care already will start the year using some kind of EHR, based on preliminary, official measurements of the National Center for Health Statistics, an arm of the Centers for Disease Control and Prevention.
The NCHS annual survey conducted between April and July 2010 asked more than 10,000 office-based physicians (excluding anesthesiologists, pathologists and radiologists): “Does this practice use electronic medical records or electronic health records (not including billing records)?” According to preliminary data in a report released in December, 50.7% of the physicians said they do use some type of system.
But the survey also queried physicians on whether their systems had any or all of 21 functions, 16 of which were deemed essential to having a “fully functional” EHR and seven of which were needed for a even a “basic” system.
Preliminary numbers show that just 10.1% of physicians were using fully functional systems, while 24.9% were using basic systems. Interestingly, the rates of adoption—that is, the differences in percentage of adoption one year over the next—dropped for undefined EHRs and basic EHRs between 2008 and 2010, while the rate of change for fully functional EHRs rose slightly.
The clock started on the Medicare and Medicaid portions of the IT incentive program Oct. 1, 2010. To get paid federal incentives, hospitals have until Sept. 30 to string together 90 consecutive days of meaningful use of an EHR system under the Medicare program, but merely adopt, implement, or upgrade a system under Medicaid. Hospitals can register and receive IT incentive payments under the Medicare and Medicaid programs.
The clock started Jan. 1 for physicians, who also have to meet 90 days of meaningful use under Medicare rules, or adopt, implement or upgrade a system under Medicaid requirements, but either within calendar year 2011. Physicians, unlike hospitals, can't double dip and receive payments under both programs.
Simultaneously, the federal government will operate a host of other programs to boost the use of health information technology, including IT workforce development programs at the junior college, undergraduate and graduate levels; funding and policy support for state-level health information exchanges; a Beacon communities program to push cutting-edge practical applications of health IT; and a system of regional health IT extension centers to assist providers in selecting and adopting EHR systems.