Interoperability report: This is how office-based physicians are using EHRs

Doctor computer keyboard
A new government report presented the first look at what types of PHI doctors are sending and receiving via their EHRs. (Getty/jacoblund)

A new government report offered a first nationwide look at what types of protected health information doctors are sending and receiving via their EHRs, a step toward understanding how to increase system interoperability.

Based on data from the 2015 National Electronic Health Records Survey (NEHRS), the report (PDF) shows most office-based physicians are using certified EHR systems for everything from sending patient referrals to accessing laboratory results and checking medication lists, according to the National Health Statistics report released by the Centers for Disease Control and Prevention.

For example, one of the most common types of shared PHI is laboratory results, sent by 67.2% of physicians, received by 78.8% of physicians and integrated into patient records by 73.2% of physicians.

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In contrast, use of registry data was one of the least commonly shared types of PHI.

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 In 2015, 77.9% of office-based physicians had a certified EHR system, up from 74.1% in 2014, according to the report. The HITECH Act provides financial incentives to eligible providers using a certified EHR and who can demonstrate meaningful use of that system.

In 2015, among office-based physicians who sent PHI electronically, the most common types were referrals (67.9%), laboratory results (67.2%) and medication lists (65.1%). Among physicians who received PHI electronically, the most common types were laboratory results (78.8%), imaging reports (60.8%) and medication lists (54.4%). Also, among the most commonly integrated PHI were hospital discharge summaries. Finally, a large majority of physicians who searched for PHI electronically did so for medication lists (90.2%), medication allergy lists (88.2%) and hospital discharge summaries (80.4%).

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The bar could get higher next year for physician practices to meet the requirements for certified EHR systems. A proposed rule (PDF) to update the Medicare physician fee schedule for next year, would require physicians to upgrade to 2015 Edition Certified Electronic Health Record Technology beginning in 2019. The rule said the 2014 edition certification criteria—currently allowed for 2018—is out of date and insufficient to meet clinician needs in the evolving health IT industry.

While physicians have long complained about the administrative burden of EHRs, a new study showed how even commonly used platforms can complicate simple tasks. The study, published in the Journal of the American Medical Informatics Association (JAMIA), suggests wide variability in the usability and safety of EHRs.

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