Docs making strides on data exchange

By Bernie Monegain
10:31 AM
Physicians in Massachusetts, Minnesota, North Dakota, Oregon, Vermont, Washington and Wisconsin show top exchange capabilities

A new ONC study shows that a majority of office-based physicians are able to view lab results and send medication data electronically. The researchers used  data from a 2011 survey of physicians.

"The results of this study are encouraging because they show that a majority of physicians who use electronic health records can electronically exchange test results, medication data and clinical care summaries with patients, all of which are integral to better care coordination and ultimately necessary for universal interoperability," said Vaishali Patel, an ONC senior advisor and lead author of the study, in a news release. "As Stage 2 of meaningful use moves forward, it will be important to continue monitoring physicians’ exchange capabilities and actual exchange activity to ensure that health information follows the patient wherever they go."

[See also: Physician approaches to HIE vary widely.]

The ONC study, published in the American Journal of Managed Care, found that the adoption of an EHR was the single strongest predictor of electronic exchange capability for e-prescribing, lab test viewing or ordering, and exchanging clinical summaries. However, results from the study show that exchange capability varies among vendors.

Key findings are:

  • 55 percent of all physicians had computerized capability to send prescriptions electronically vs. 78 percent of physicians with an EHR.
  • 67 percent of all physicians could view electronic lab results vs. 87 percent of physicians with an EHR.
  • 42 percent could incorporate lab results into their EHR vs. 73 percent of physicians with an EHR.
  • 35 percent could send an electronic order to a lab vs. 54 percent of physicians with an EHR.
  • 38 percent could provide clinical summaries to patients vs. 61 percent of physicians with an EHR.
  • 31 percent exchanged patient clinical summaries with another provider vs. 49 percent of physicians with an EHR.

Results of the study indicate that there was variation among physician exchange capability at the state-level. Physicians in Massachusetts, Minnesota, North Dakota, Oregon, Vermont, Washington and Wisconsin reported the capability to exchange clinical information at rates significantly higher than the national average in at least 4 out of 6 measures of exchange capability examined. 

[See also: Physicians point to business case for HIE.]

The study authors suggest that the Medicare and Medicaid EHR Incentives Programs and the State Health Information Exchange Program may drive improvement in physician exchange capability. The study also suggests that healthcare delivery reforms contained in the Patient Protection and Affordable Care Act, including accountable care organization and shared savings programs, are likely to provide financial incentives to spur even greater health information exchange. 

“Specifically, accountable care organizations, which allow entities to share cost savings, may create a business case for HIE by giving providers greater financial incentives to exchange information regarding their patients with each other," ONC researchers wrote. "Additionally, financial penalties for high hospital readmission rates, for example, may spur greater care coordination between hospitals and ambulatory care providers to better manage transitions of care through the use of care summaries."

Data for this study are from the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics as an annual, nationally representative survey of office-based physicians that collects information on the adoption and use of EMR/EHR systems. The target universe of the NAMCS is physicians providing direct patient care in office-based practices, including physicians in community health centers. Radiologists, anesthesiologists, and pathologists are excluded.  The overall sample consisted of 4,326 physician respondents, with a 61 percent weighted response rate. The sample size is sufficient to generate state-level and national estimates.