Sunny outlook for small practice EMR adoption, meaningful use cloudy

By Molly Merrill
10:29 AM

The percentage of small physician practices that are planning to implement an EMR has grown in the last six months, according to a new vendor survey. But while the percentage of respondents who said the American Recovery and Reinvestment Act (ARRA) was driving technology adoption more than doubled during this period, most are still unaware of requirements and nearly half say it will not impact their buying decision.

Cambridge, Mass.-based NaviNet, America's largest real-time healthcare communications network, conducted the survey via email earlier this month, targeting physician practices with 10 or fewer physicians. The survey generated 269 responses.

NaviNet compared its March 2010 survey with one conducted in August 2009 and found that EMR implementation was higher than expected among this segment. In 2009, only nine percent of respondents from provider practices with 10 or fewer physicians reported that they planned to implement EMRs within the next six months. Six months later in 2010, 12 percent are currently implementing.


The survey found that 17 percent of respondents say their offices will implement a new EMR by end of 2011. Of those, 68 percent will do so within the next 12 months. If EMR adoption follows previous growth rates, the industry can expect an even higher percentage of practices implementing EMRs than predicted, NaviNet projects.

The percentage of respondents with no plans to implement an EMR has decreased significantly, the survey found. In 2009, 31 percent reported they had no plans to implement EMR. In 2010, only 21 percent say the same.

The NaviNet survey indicates that nearly twice as many provider offices' IT buying decisions are driven by concern about not being reimbursed versus the potential to earn incentives.

In 2010, when respondents were asked what external factors were influencing their offices' decisions about changes to technology, 53 percent said CMS mandates––a 14 percent spike over 2009.

Administrative concerns continue to be a pressing issue for providers, more so than clinical concerns or potential financial incentives. Nearly the same percentage of respondents in 2009 and 2010 cited the need to manage their practices' administrative overhead more effectively as a driver behind IT adoption––44 percent in 2009, 45 percent in 2010.

The survey results show that the opportunity to receive incentives from ARRA after meeting the CMS criteria for "meaningful use" of technology is becoming more important; in just six months the percentage of respondents that said ARRA was driving technology adoption more than doubled––12 percent in 2009 to 27 percent in 2010.

That said, the survey found that in 2010 most practices are still unsure or unaware of meaningful use reporting requirements and nearly half of practices say ARRA will not impact their technology buying decisions:

  • Only about one quarter (26 percent) of respondents said that they plan on following CMS' guidelines for meaningful use to qualify for incentive payments provided by ARRA;
  • More than 60 percent (63 percent) said they were unaware or unsure of what the meaningful use reporting requirements are; and
  • Nearly half of respondents (48 percent) said that meaningful use requirements will not impact their EMR buying decisions.

"The NaviNet survey results are encouraging, as they suggest that small physician practices are getting more serious about HIT adoption," said Brad Waugh, president and CEO of NaviNet. " Furthermore, it is also encouraging to see federal incentive programs having more of an impact on IT adoption. However, it is clear that opportunities remain for education about how to meet Federal requirements. Providers would benefit from knowing that a wide variety of IT solutions, in addition to EMRs, will satisfy their office's business requirements and also the clinical criteria for Meaningful Use. Many physicians already have these solutions in their offices—so additional investment could be minimal or unnecessary."


In 2010, nearly 50 percent of  NaviNet survey respondents said that cost remains the biggest barrier to EMR adoption. Other barriers cited by respondents were:

  • Forty-six percent of physicians said they are not ready to pursue adoption;
  • Twenty-seven percent of practices say they do not need an EMR; and
  • Twenty-six percent of practices do not how they will achieve return on investment.

Click here to view graphs from the study.