There’s been no shortage of reports on the fact that smaller providers are making the HIT leap much more slowly than larger ones. But a new study from Health Affairs notes that small providers who have moved to EHRs still aren’t making as full use of them as larger providers.
As this article puts it, “a national study of small and midsize physician practices finds that, although a quarter of them use electronic health records for progress notes, much smaller percentages are using those EHRs for the functions that specialty societies have defined as essential components of the patient-centered medical home. These elements include electronic disease registries, electronic prescribing, online messaging with patients, improvement of care processes, and care coordination across healthcare settings.”
While the study focused on connecting EHR use to the demands of emerging care processes such as patient-centered medical homes, the findings would seem to have some overall implications for policymakers to ponder.
To take just one example, let’s consider the survey’s finding that, on average, “practices ranging from one to 19 doctors . . . use only about a fifth of the care processes required for medical homes.” Now, we haven’t taken the time to compare current and proposed MU requirements to the medical home or ACO requirements, but we’re pretty sure there’s some overlap.
Now, let’s factor in the percentage of the nation’s healthcare providers who fall into the “small and midsize” category. If those providers are only using their EHRs at about one fifth capacity, when measured in ACO/MU terms, what can we project about the highly-touted efficiencies and improvements in care that HIT proponents have long been promoting?
As always, none of this is to suggest the HIT transition isn’t going to happen, or that we aren’t going to see, over time, some tangible benefits to the move. Rather, it’s to remind policymakers once again that, in the long-run, it’s the little guys who are going to determine how long the HIT transformation of the healthcare system is really going to take.
