Physician and Practice‐Level Drivers and Disparities around Meaningful Use Progress

Objective. To identify physician and practice characteristics that are markers of success for meaningful use of electronic health records (EHRs). Data Sources. American Medical Association survey, Centers for Medicare & Medicaid Services' (CMS) EHR Incentive, Pioneer Accountable Care Organization, and PECOS Programs, the Office of the National Coordinator for Health IT's Regional Extension Center Program, and National Committee for Quality Assurance Patient‐centered Medical Home certification program. Study Design. Retrospective analysis of 865,370 physicians' participation in CMS's EHR Incentive Program and progress to stage 1 Meaningful Use between 2011 and 2013. Physician specialty, age, practice size, geographic markers, delivery reform participation, and technical assistance receipt were predictive elements. Principal Findings. Medicaid physicians were progressing more slowly to Meaningful Use than Medicare physicians: by 2013, 8 in 10 physicians registered with Medicare had achieved meaningful use, compared to one‐third of Medicaid‐registered physicians. The strongest predictors of meaningful use were technical assistance (79 percent more likely) and delivery reform participation (34 percent more likely). Conclusions. Continued outreach and technical assistance that demonstrates strong interactions between meaningful use of health IT and delivery reform may facilitate further adoption of both initiatives.

[1]  Steven R. Simon,et al.  Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey , 2006, AMIA.

[2]  C. Redhead The Health Information Technology for Economic and Clinical Health (HITECH) Act , 2009 .

[3]  Nir Menachemi,et al.  EHR adoption among doctors who treat the elderly. , 2010, Journal of evaluation in clinical practice.

[4]  Farzad Mostashari,et al.  The Health IT Regional Extension Center Program: evolution and lessons for health care transformation. , 2014, Health services research.

[5]  Julia Adler-Milstein,et al.  Despite substantial progress In EHR adoption, health information exchange and patient engagement remain low in office settings. , 2014, Health affairs.

[6]  Donna Spiegelman,et al.  Easy SAS calculations for risk or prevalence ratios and differences. , 2005, American journal of epidemiology.

[7]  D. Blumenthal,et al.  The "meaningful use" regulation for electronic health records. , 2010, The New England journal of medicine.

[8]  Sander Greenland,et al.  Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies. , 2004, American journal of epidemiology.

[9]  Robert L Phillips,et al.  Factors Influencing Family Physician Adoption of Electronic Health Records (EHRs) , 2013, The Journal of the American Board of Family Medicine.

[10]  M. Furukawa,et al.  EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption. , 2014, Healthcare.

[11]  Ashish K. Jha,et al.  Electronic health records in small physician practices: availability, use, and perceived benefits , 2011, J. Am. Medical Informatics Assoc..

[12]  Eric W. Jamoom,et al.  Physicians in nonprimary care and small practices and those age 55 and older lag in adopting electronic health record systems. , 2012, Health affairs.

[13]  Farzad Mostashari,et al.  The Regional Extension Center Program: Helping Physicians Meaningfully Use Health Information Technology , 2010, Annals of Internal Medicine.

[14]  Sarah Hudson Scholle,et al.  Easing the adoption and use of electronic health records in small practices. , 2010, Health affairs.

[15]  M. Buntin,et al.  Geographic variation in ambulatory electronic health record adoption: implications for underserved communities. , 2013, Health services research.

[16]  E. Hing,et al.  Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001-2013. , 2014, NCHS data brief.

[17]  Valerie A. Lewis,et al.  First national survey of ACOs finds that physicians are playing strong leadership and ownership roles. , 2014, Health affairs.

[18]  Steven R. Simon,et al.  Correlates of electronic health record adoption in office practices: a statewide survey. , 2007, Journal of the American Medical Informatics Association : JAMIA.

[19]  Francie Ostrower THE URBAN INSTITUTE , 2004 .

[20]  C. DesRoches,et al.  Health Information Technology in the United States: Progress and Challenges Ahead 2014 , 2014 .

[21]  G. Zou,et al.  A modified poisson regression approach to prospective studies with binary data. , 2004, American journal of epidemiology.

[22]  M. Gagnon,et al.  Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review , 2011, BMC medicine.

[23]  Josephine Antonette Curcio Publication No. _______ , 2003 .

[24]  A. Jha,et al.  Office-based physicians are responding to incentives and assistance by adopting and using electronic health records. , 2013, Health affairs.

[25]  E. Norton,et al.  What's the Risk? A simple approach for estimating adjusted risk measures from nonlinear models including logistic regression. , 2009, Health services research.