Smaller practices not implementing all EHR features

In a new review of medical home processes by small to medium-size physician practices, the use of electronic medical record (EMR) systems by those practices appeared to be on the low side when compared with larger practices or those owned by hospitals or health plans, according to a new study in the current Health Affairs. The study surveyed 1,344 small and medium-sized physician practices with one to 19 physicians.

According to the study, about 17 percent of practices with one or two physicians had EMRs, compared with 38 percent of practices with three to seven physicians, 45 percent of practices with eight to 12 physicians, and 39 percent of practices with 13 to 19 physicians.

In addition, less than 19 percent of smaller practices had e-prescribing tools, compared with 28 percent of the entire group; and 6 percent of smaller practices had electronic disease registries, while 34 percent of practices with 13 to 19 doctors used them to communicate with patients who needed preventive or chronic care. Overall, the majority of physicians communicated online with patients in less than 9 percent of the practices.

To encourage smaller practices to adapt strategies that promote the adoption of medical home processes, such as using EMRs, strategies could be implemented that promote assistance from a variety of sources external to the practice, such as multipayer initiatives, federal extension centers, or accountable care organizations.

Another potential strategy would be for small practices to share resources, such as care managers, through an independent physician association, or with help from a health plan or government payer, such as Medicaid, the researchers suggested.

For more information:
- check out the Health Affairs study
- read Ken Terry's article in InformationWeek