Health Affairs published three new studies that examine meaningful use attestation among eligible professionals and hospitals and highlight the challenges providers face.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Hospitals Struggle With Stage 2 Attestation

In one study, researchers analyzed data from the IT supplement of the American Hospital Association Annual Survey, which included responses from 2,674 short-term acute care general hospitals (Neuhauser, U.S. News & World Report, 8/7).

The researchers identified a lag in the number of hospitals using some form of an EHR system with which they are able to attest to Stage 2 of the meaningful use program.

Specifically, they found that by 2013:

• 53% of hospitals had either adopted a basic or comprehensive EHR;
• 41% of hospitals had not adopted either a basic or comprehensive EHR; and
• 5.8% of hospitals had adopted EHR systems that could meet Stage 2 meaningful use requirements (Tahir, Modern Healthcare, 8/7).

However, the study did not show a large disparity in EHR adoption between critical access and other hospitals (Murphy, EHR Intelligence, 8/7).

The study authors said that the main issues preventing hospitals from being able to attest to Stage 2 surround health data exchange and data sharing among care delivery organizations and patients (Modern Healthcare, 8/7). 

According to Healthcare IT News, the findings indicate the large number of hospitals could face financial penalties in January 2015 if they fail to meet Stage 2 requirements (McCann, Healthcare IT News, 8/7).

EHR, HIE Adoption Among Physicians Lags

Meanwhile, a separate study published in the journal Health Affairs showed persistent gaps in EHR adoption and health information exchange among providers.

For the study, researchers analyzed data from the 2009 National Ambulatory Medical Care Survey and the 2009-2013 Electronic Health Records Survey.

Overall the study showed that in 2013:

• 78% of office-based physicians had adopted an EHR system; and
• 48% of those with an EHR met requirements for a basic EHR system.

However, the study showed that solo practitioners lagged behind others, with 66% of physicians in practices with at least 11 physicians having a basic EHR, compared with 37% of solo practitioners.

In addition, the study showed:

• 30% of physicians regularly sent patients secure messages; and
• 24% typically provided patients with online access to their health records where they could download or transmit their data.

The study also found limited health information exchange among physicians, with just 14% sharing data with providers outside of their organization.

The study authors said the data show a need for policies to support health information exchange and patient engagement (Furukawa et al., Health Affairs, August 2014).

EHR Implementation Costs Run High

Meanwhile, another study published in the journal Health Affairs examined the cost of implementing EHR systems at primary care practices in a Texas-based physician care network (Fleming, Health Affairs, August 2014).

The study found that the average first-year investment costs for a physician practice with five providers is $162,000, plus an additional $85,000 in maintenance fees (Millman, "Wonkblog," Washington Post, 8/7).

The researchers also estimated that the implementation team required an average of 611 hours to prepare for and implement the EHR system, while physicians and other clinical staff needed 134 hours each to prepare for the new system (Fleming, Health Affairs, August 2014).

Reaction

During a briefing on the studies, National Coordinator for Health IT Karen DeSalvo praised the investments and progress made in advancing EHRs. She noted that moving forward, ONC will need to refocus priorities surrounding EHR adoption and health IT strategic planning (Dvorak, FierceEMR, 8/7).

Meanwhile, Julia Adler-Milstein -- a study co-author with the University of Michigan School of Information and Public Health -- said she thinks the health industry needs "to think seriously about how we get the remaining 40% [of hospitals] up and running and whether incentives may not be enough to bring them along" (Modern Healthcare, 8/7).