Docs identify barriers to meeting Stage 3 care coordination criteria

Many physicians view electronic care coordination in a positive light, but are concerned about the obstacles that could hinder their efforts to meet such criteria in Stage 3 of Meaningful Use, according to a new study in the Journal of the American Medical Informatics Association.

The researchers, Genna Cohen and Julia Adler-Milstein of the University of Michigan, note that there is a big difference in the requirements to electronically exchange data from Stage 1 of the Meaningful Use program to Stage 3.

They conducted a statewide survey of primary care practices that have met Stage 1, with 233 practice managers and 174 primary care physicians responding. Eighty-six percent of the physician respondents agreed that Stage 3 could improve patient treatment, and 85 percent said that it will help patients overall. What's more, 85 percent agreed that care coordination will help them know about patients' visits with other doctors.

However, there were low rates of information sharing overall. Practices were more likely to share within their network (40 percent) compared to outside their network (5 percent). Only 2 percent of respondents received electronic information from out of network ambulatory practices.

Care coordination is one of the primary goals of the Meaningful Use program and of health reform, but a lack of interoperability continues to adversely impact these efforts. The Office of the National Coordinator for Health IT has created a roadmap to support these endeavors.

In addition, the respondents identified six substantial or moderate barriers to meeting the Stage 3 care coordination criteria. The top obstacles included difficulty sending and receiving the data; a lack of provider and practice staff time; and complex required workflow changes. Other barriers included financial costs, EHR design and functionality, competing priorities and lack of trust in the accuracy of the information.  

"There are many barriers to primary care practices achieving the proposed Stage 3 Meaningful Use care coordination criteria," the researchers said. "Despite these barriers, there is widespread agreement among PCPs that meeting the proposed Stage 3 Meaningful Use criteria is likely to broadly improve patient care coordination. This suggests that we should continue to support and tailor policy efforts to enable practices to overcome barriers to achieving these criteria."

To learn more:
- here's the study abstract