Issue link: https://viewer.e-digitaledition.com/i/696420
EIG HT Y‡THREE PERCENT OF U. S. physicians use EHRs, although a slim majority — 51 percent — use only the system's basic functions, according to a 2015 report by the O• ce of the National Coordinator for Health IT. The report identifi es primary care physicians (PCPs) as the most enthusiastic EHR adopters. Practice size is also a key determinant. In its 2015 Ambulatory EHR User Satisfaction and Loyalty Survey, Black Book Market Research LLC — a healthcare-focused polling, sur vey a nd ma rket resea rch opinion-mining company headquartered in Tampa, Florida — found 99.4 percent of practices with at least 50 physicians had adopted EHRs. Roughly the same percent- age of practices with 10 to 49 physicians had adopted EHRs, and about 68 percent of practices with two to nine clinicians had done so. Among solo practitioners, the adoption rate was 58 percent. The Black Book survey also revealed a steep plunge for MU incentives as a motivating factor in adoption. In 2013, these incentives spurred 95 percent of EHR purchases; last year, they drove only 7 percent of EHR acquisitions, mostly for replacement systems. "MU is focused on adoption and use of EHRs as the fi nal goal, which misses the whole point: that IT in health care ... is a means to achieve the actual goal of e• ciency," says Niam Yaraghi, PhD, Fellow in Governance Studies at the Center for Technology Information at the Brookings Institution, a Washington, D.C., think tank. "More importantly, MU considers EHRs as the only type of IT solution and ignores the fact that there are many other IT services that can help medical providers much more. Current EHRs are not designed to meet the needs of o• ce-based physicians. They are so burdensome and expensive that many physicians will be better o paying the MU penalties rather than adopting these technologies. Given these factors, the low adoption rate of EHRs among individual physicians is not a surprise; rather, it is the expected outcome." MEET THE NON-ADOPTERS Solo or small-practice clinicians — par- ticularly those who share few patients with other practices — as well as certain specia lists a nd physicia ns in single- specialty practices have lagged behind PCPs a nd clinicia ns in la rge a nd/or multispecialty groups in EHR adoption, according to experts and research by the American Academy of Family Physicians. Non-adopters may practice in less tradi- tional settings, one expert says. "I believe [non-adopters] are subspecial- ists or providers who work in non-hospital and non-clinic environments, or they do not have their own o• ces, such as hospitalists who use EHRs but not ambulatory EHRs," says Joan S. Ash, PhD, MLS, MS, MBA, Professor and Vice Chair of the Department of Medica l Informatics a nd Clinica l Epidemiology at the School of Medicine THE EHR ADOPTION R ATE AMONG PHYSICIANS IN THE UNITED STATES IS HIGH © GRE ATER THAN 80 PERCENT, ACCORDING TO FEDER AL GOVERNMENT DATA © BUT WITH FEDER AL ME ANINGFUL USE £MU¤ INCENTIVES DRYING UP, WHAT WILL IT TAKE TO GE T THE HOLDOUTS ON BOARD? Factors: Motivating Future EHR Adoption BY THOMAS CROCKER Potential Drivers of 2 0❱❱❱❱❱ S P E C I A L F E A T U R E