Eric Jamoom and Chun-Ju Hsiao National Center for Health Statistics

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1 What does Meaningful Use mean to office-based physicians? Eric Jamoom and Chun-Ju Hsiao National Center for Health Statistics AcademyHealth Annual Research Meeting June 24, 2013 National Center for Health Statistics Division of Health Care Statistics

2 Objectives To describe differences in select computerized capabilities associated with the Stage 1 Meaningful Use (MU) objectives among physicians that report their EHR meets the MU criteria

3 Background HITECH Act Meaningful Use Incentive Program EHR adoption trends 14% of office-based physicians had EHR systems with 10 of the 15 Stage 1 core set objectives in % of physicians self-report they have a system that meets the MU criteria. SOURCE: National Ambulatory Medical Care Survey EMR Supplement and Physician Workflow study, NOTES: Caption: MU is meaningful use.

4 3 Stages: EHR Meaningful Use Stage 1 Data capture and sharing ( ) Stage 2 Advanced clinical processes ( ) Stage 3* Improved outcomes ( ) *Stage 3 will be defined in future CMS rulemaking. Source : Centers for Medicare & Medicaid Services (CMS)

5 Methods: Data Sources NAMCS EMR Supplement 2011 Content: Tracks EHR adoption, select computerized capabilities, intent to apply for MU, HIE NAMCS Physician Workflow Supplement 2011 Follow-up to the 2011 NEMRS Content Barriers to using EHRs Attitudes about using EHRs Policies that influence adoption of EHRs

6 2011 Workflow Study Flow Chart Total NAMCS EMR Mail Sample (N=10,302) Out of scope (n~3100) Unknown (n~ 1,900) IN SCOPE EMR Mail Sample (n=5,266) Refusals (n=709) EMR Respondent (n=4,557) Workflow Respondent (n=3180) Adopters N=1793 Non Adopters N=1387 Analytical sample: 1,134 respondents to both EMR and Workflow surveys self-reported their EHR meets MU Criteria

7 Results SOURCE: National Ambulatory Medical Care Survey EMR Supplement and Physician Workflow study, NOTES: Caption: MU is meaningful use.

8 Results Computerized capabilities among adopters with an EHR that meets Meaningful Use criteria About 80% or more had the following computerized capabilities: Record patient history and demographics Order entry for prescriptions Record comprehensive medication and problem list Send prescriptions to pharmacy electronically (e-rx) Drug-drug interactions/ contraindication warnings About 2 of 3 physicians had the following computerized capabilities: Clinical summaries for patients at each visit Provide reminders for guideline based for interventions/screening Meeting above capabilities of Stage 1 MU (43%) Health information exchange of summaries (55%)

9 Discussion Among physicians who report that they use an EHR that meets meaningful use criteria, 57% did not have an EHR with the select required capabilities under the MU Stage 1 Core Set objectives. Discrepancies exist among physicians perceptions of meeting MU and having select computerized capabilities associated with meeting MU criteria. Implications for physicians having an EHR that meets subsequent stages of the MU criteria.

10 Limitations Time and respondent differences between EMR and workflow Workflow survey lagged by ~2 months from their completion of EMR survey (possible temporal effects). Respondents completing EMR and Workflow questionnaires may not be the same Survey did not contain all 15 core capabilities associated with MU Conservative estimate Measuring the core capabilities associated with MU and meeting MU was based on self-report (not objective)

11 NAMCS: EMR mail survey NAMCS: Physician Workflow Study Acknowledgments: - National Center for Health Statistics, Centers for Disease Control & Prevention (CDC) - Office of the National Coordinator for Health Information Technology (ONC) For more information please contact Eric Jamoom at the National Center for Health Statistics 3311 Toledo Road, Room 3304, Hyattsville, MD Telephone: (301) Web: DISCLAIMER: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Health Statistics Division of Health Care Statistics

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