BETHESDA, MD – The good news is that 90.6 percent of physicians working in general or family practice or internal medicine could qualify for federal incentives if they can meet meaningful use criteria.

The bad news? Less than two-thirds of pediatricians, obstetrician-gynecologists and psychiatrists may be eligible, according to a study published in Health Affairs.

The study found that 82.6 percent of office-based physicians could qualify for incentives – from Medicare, Medicaid or a combination of the two – if they met meaningful use criteria.

“The financial assistance provided by these incentives, in conjunction with other initiatives, should greatly accelerate adoption and meaningful use of electronic health records, making the potential benefits of health information technology more widely available,” said Brian Bruen, lead research scientist in the George Washington University Department of Health Policy and lead author of the article.

Authors broke physician eligibility into four categories:

· 70.5 percent of physicians are eligible for incentives, but don’t have a basic EHR. According to the authors, this represents most office-based physicians.

· 14.6 percent of physicians aren’t eligible for incentives and don’t have a basic EHR. (Eligibility is based on the number of Medicare and Medicaid patients seen.) This is the group authors say is the most likely to resist EHRs.

· 12.1 percent of physicians are eligible for incentives and already have a basic EHR.

· 2.8 percent of physicians are not eligible for incentives and already have a basic EHR.

“Generally, these seem (like) realistic numbers,” said David C. Kibbe, MD, senior advisor for the American Academy of Family Physicians and chairman of standards organization for ASTM International’s E31Technical Committee on Healthcare Informatics. Kibbe is also principal of The Kibbe Group.

“Over 60 percent of AAFP members in active practice do have an EHR,” he said, “but many of them won't seek MU achievement in 2011.”

The reasons are many, Kibbe said, including expensive upgrades needed to meet MU and a lack of confidence that the incentives will actually materialize. “In one word – uncertainty,” he said.

The study found that physician eligibility for incentives varied by specialty, type and size. It found that psychiatrists, above all other specialists, were "significantly less likely to use EHRs."

The authors also note that physicians in a solo practice are less likely to use EHRs and qualify for incentives, and physicians in practices owned by a health maintenance organization were the least likely to be eligible for incentives.

The geographic location of the doctor also mattered: Physicians in the Midwest were more likely to qualify for incentives and those in the West were less likely to qualify, according to the authors.

“As these programs take effect, it will be important to monitor the gaps in eligibility for the EHR incentive programs and use of electronic health records, as these gaps may lead to digital divides that hinder efforts to integrate care across providers,” said Leighton Ku, a professor of health policy and co-author of the article.