Docs who don't adopt EHRs face 'unique' challenges

Physicians who have not transitioned to electronic health records face a "unique" set of challenges that limits their ability to make the change, according to a study and article in the Annals of Internal Medicine.

The researchers, from Mathematica Policy Research in Cambridge, Massachusetts, found that while many physicians have adopted EHRs, some don't plan to and some who have are opted not to participate in the Meaningful Use program, which could impact the success of the program and the need to implement other, broader changes.

The researchers conducted a survey of 3,437 U.S. physicians engaged either in primary care or in specialties where they would likely care for a given patient over a period of time. The researchers found that by 2013, 63 percent of respondents had an EHR and another 20 percent were in the process of implementing one.

However, 9 percent had no plan to adopt an EHR at all. Those physicians were more likely to be older, in a one- or two-physician practice, primarily reimbursed on a fee-for-service basis, less likely to be enrolled in an incentive program that focused on quality of care and less likely to receive additional payments for managing patients with complex needs or chronic conditions.

"Failure to address the needs of these physicians has implications beyond adoption because new models of healthcare delivery require the use of an EHR," the researchers said. "Physicians who choose not to make the change to EHRs may find themselves further isolated if these new models become widespread, but they may move toward adoption as the penalty phase of the Meaningful Use program draws closer. If so, they are likely to require extensive support in selecting, implementing and using these systems."

Physician adoption of EHRs also appears to be leveling off.

A recent SK&A survey found adoption increasing only 2.8 percent from January 2014 to January 2015; it now stands at 62.8 percent.

However, it is becoming increasingly important to use EHRs from a financial standpoint; many of the Centers for Medicare & Medicaid Services' new payment models require EHR use or Meaningful Use participation as a condition of payment.

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