'Digital divide' persists in health IT adoption

Adoption of electronic medical records by primary care physicians has grown substantially, but the "digital divide" between large and small physician practices persists, according to a new study from the Commonwealth Fund.

Between 2009 and 2012, adoption grew from 46 percent to 69 percent. A majority of physicians use core health IT functions such as e-prescribing, electronic ordering of lab tests and certain types of clinical decision support.

Practice size, however, is the major factor affecting adoption. Ninety percent in practices of 20 or more physicians use EMRs, compared to just half of those in solo practices.

In 2012, 33 percent of primary care physicians could exchange clinical summaries with other doctors, and 35 percent could share lab or diagnostic tests with doctors outside their practice. Roughly one-third offered electronic access to patients.

Physicians who are part of an integrated delivery system, such as Kaiser Permanente or the Veterans Administration, practices that share resources or those eligible for financial incentives have higher rates of health IT adoption.

The report's authors suggest that technical assistance programs and financial incentives can help close this "digital divide." In addition, they say, physician practices remain behind schedule in their preparation for ICD-10.

In a recent survey of physician practices, 75 percent of respondents said they still haven't started implementation of their ICD-10 transition plan, but still think they'll be ready by the Oct. 1 deadline.

Meanwhile, new National Coordinator for Health IT Karen DeSalvo says the "next chapter" of the ONC's work will focus on harnessing health IT for, among other things, population health: "[T]o see the promise of health information technology in the clinical interface for the health systems and the population and community at large to come to fruition," she said at a recent Health IT Policy Committee meeting.

ONC and the U.S. Department of Health & Human Services Office for Civil Rights are developing a risk assessment tool due out later this year to help small providers navigate the privacy and security requirements suggested for Meaningful Use.

To learn more:
- find the study

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