ED, Outpatient Providers Struggled To Meet EHR Goals
While the adoption of electronic health records among emergency and outpatient departments increased between 2006 and 2011, physicians in such departments largely struggled to use the EHR systems to achieve meaningful use objectives, according to a new report released by CDC's National Center for Health Statistics, Medscape reports.
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (Terry, Medscape, 2/19).
The report was based on data from the 2006-2011 National Hospital Ambulatory Medical Care Survey of EDs and outpatient departments in non-federal, general and short-stay hospitals.
The report found that EHR use between 2006 and 2011 increased from:
- 46% to 84% in EDs; and
- 29% to 73% in outpatient departments (Frieden, "The Gupta Guide," MedPage Today, 2/19).
However, just 14% of EDs and 16% of outpatient departments by 2011 had EHR systems that could support at least nine of the 14 Stage 1 objectives under the meaningful use program (Medscape, 2/19).
The report also found that the percentage of EDs and outpatient departments that used an EHR system capable of supporting four specific Stage 1 objectives increased during the study time period. For example, among EDs in 2011:
- 65% of EHRs supported recording patient problem lists, compared with 45% in 2006;
- 63% of EHRs supported ordering prescriptions, compared with 39% in 2006;
- 43% of EHRs were capable of providing warnings of drug interactions or contraindications, compared with 28% in 2006; and
- 40% of EHRs were capable of offering guideline-based interventions, compared with 28% in 2006.
In addition, the report found that among outpatient departments in 2011:
- 70% of EHRs supported recording patient problem lists, compared with 28% in 2006;
- 60% of EHRs supported ordering prescriptions, compared with 27% in 2006;
- 48% of EHRs were capable of providing warnings of drug interactions or contraindications, compared with 21% in 2006; and
- 46% of EHRs were capable of offering guideline-based interventions, compared with 21% in 2006 ("The Gupta Guide," MedPage Today, 2/19).
James Augustine -- vice president of the Emergency Department Benchmarking Alliance and a board member of the American College of Emergency Physicians -- said one reason EDs could have struggled to meet various meaningful use objectives was because the federal government "didn't necessarily set the right targets for what's necessary to support patient care in the ED."
Augustine added that the EHR systems used by various EDs "may not yet have had all of the functions that allow [providers] to order drugs and provide warnings and provide reminders on specific guidelines."
He noted that EHR use among EDs could have changed since the survey (Medscape, 2/19).
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