TABLE OF CONTENTS. List of Figures iii. List of Tables v. I. Introduction 1. A. New Technology & EHR Survey 1. B. Types of Electronic Systems 1
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1 TABLE OF CONTENTS List of Figures iii List of Tables v Page I. Introduction 1 A. New Technology & EHR Survey 1 B. Types of Electronic Systems 1 C. Types of Optometrists 1 II. Characteristics of Responding Optometrists 3 III. Electronic Systems Utilized 7 IV. Clinical Use of Technology 15 A. Equipment 15 B. Medication Prescriptions 26 V. Internet/ Web Use of Technology 28 VI. Practice Management Use of Technology 32 A. Components of Practice Management Software 32 B. Practice Management Software Utilized 38 VII. Electronic Health Record Systems Utilized 39 VIII. Meaningful Use of Electronic Health Record Systems 44 A. Insurance Claim Processing 45 B. Meaningful Use Objectives All Responding EHR Users 46 C. Achieved Meaningful Use and Attested in Either 2011 or i
2 Page D Stage 1 Meaningful Use Achieved Meaningful Use and Attested in 2013 or Plan to Achieve and Attest in 2014 with Certified EHR Technology (CEHRT) 53 E Stage 1 Meaningful Use Achieved Meaningful Use and Attested in 2013 or Plan to Achieve and Attest in 2014 without Certified EHR Technology (CEHRT) 56 F. Not Currently Planning to Achieve Meaningful Use and Attest OR Failed to Respond to Question 59 IX. Comments 63 X. Summary 63 XI. Survey Methodology 64 A. Population and Survey Sample 64 B. Data Collection 64 C. Calculations 64 XII. Glossary of Terms 65 ii
3 LIST OF FIGURES Page Figure 1: Distribution of Optometrist by Primary Practice Type 3 Figure 2: Distribution of Optometrists in Private and Corporate Practice by Employment Situation, Figure 3: Primary Practice Type of Optometrists by AOA Membership Status, Figure 4: Years in Practice by Gender, Figure 5: Percentage of Optometrists using a Complete EHR System and Corresponding Error Bars, Figure 6: Systems Used in the Primary Practice of Optometrists by AOA Membership Status, Figure 7: When Optometrists Plan to Acquire a Complete EHR and if Not Planning to Acquire, Why, Figure 8: Barriers Preventing Optometrists from Implementing EHR, Figure 9: Predicted Probabilities of Complete EHR Use against Age, Figure 10: Equipment Utilized and Planned for Acquisition among Optometrists, Figure 11: Trends in Equipment Utilization among Optometrists, Figure 12: Equipment Utilization of Optometrists by System Usage, Figure 13: Ophthalmic Equipment Utilized by EHR Users and Whether or Not Equipment Interfaces with EHR System, Figure 14: Spending Amounts Planned for Clinical Equipment, Figure 15: Perceived Profitability from Clinical Equipment Purchases, Figure 16: How Medication Prescriptions are Provided to Patients, Figure 17: Average Percentage of Total Medication Prescriptions Provided to Patients by Optometrists, _ 27 Figure 18: Percentage of Total Medication Prescriptions Provided to Patients by System Used by Practice, Figure 19: Use of AOA-Related Internet Sites by Optometrists, Figure 20: Use of Technology to Obtain Optometric Information, Figure 21: Use of Social Media, iii
4 Page Figure 22: Preferred Method to Review Clinical Research Studies, Figure 23: Percentage of Total Items Ordered Online in Last Six Months for Optometry Practices, Figure 24: Components of Practice Management Software Utilized by Optometrists, Figure 25: Utilization of Practice Management Software Components by Optometrists, Figure 26: Components of Practice Management Software Used by System Used, Figure 27: Practice Management Software Components that Interface with Current EHR System, Figure 28: Practice Management Software Utilized by Optometrists, Figure 29: EHR Systems Utilized by Optometrists, Figure 30: When Primary Practice Implemented EHR, Figure 31: Type of EHR System Design by Year, Figure 32: Satisfaction with EHR System by Year 42 Figure 33: Benefits of EHR Use Experienced by Optometrists by Year, Figure 34: When EHR Users Plan to Achieve Meaningful Use, Figure 35: Insurance Claims Submitted Directly from EHR System, Figure 36A: Percentage of Optometrists Using EHR to Perform Meaningful Use Objectives, Figure 36B: Percentage of Optometrists Using EHR to Perform Meaningful Use Objectives, Figure 37: Percentage of EHR Users Experiencing Difficulties, iv
5 LIST OF TABLES Page Table 1: Demographic Characteristics of Optometrists by AOA Membership Status, Table 2: Distribution of Optometrists by Years in Practice, Table 3: Electronic System Utilized by U.S. Census Region, Table 4: Association of Optometrist Characteristics with EHR Use, Table 5: EHR Use by Employment Situation, Controlling for Gender, Table 6: EHR Use by Employment Situation, Controlling for AOA Membership Status, Table 7: EHR Use by Employment Situation, Controlling for Practice Type, Table 8: EHR Use by Employment Situation, Controlling for Years in Practice, Table 9: EHR Use by Employment Situation, Controlling for U.S. Census Region, Table 10: Analysis of Parameter Estimates, Table 11: Equipment Utilization among EHR Users and Non-EHR Users, Table 12: Equipment Utilization among AOA Member Optometrists and Non-AOA Member Optometrists, 2014 _ 19 Table 13: Equipment Utilization by Employment Situation, Table 14: Equipment Usage by Practice Type, Table 15: Equipment Usage by Years in Practice, Table 16: Equipment Usage by U.S. Census Region, Table 17: Alternative Equipment Planned to Purchase or Lease, Table 18: Frequency of Visits to Websites for Information Related to Optometry, Table 19: Frequency of Visits to Websites for Information Related to Optometry by AOA Membership Status, Table 20: Practice Management Software Component Usage among EHR and Non-EHR Users, Table 21: Practice Management Software Component Usage among Females and Males, Table 22: Practice Management Component Usage among AOA Members and Non-AOA Members, Table 23: Practice Management Component Usage by Employment Situation, v
6 Page Table 24: Practice Management Component Usage by Practice Type, Table 25: Other Practice Management Systems Utilized by Optometrists, Table 26: Type of System Design Utilized by Employment Situation, Table 27: EHR Systems Used by Optometrists Who Indicated Their System Was Not Certified by ONC, Table 28: Percentage of Optometrists Reporting EHR Capability to Perform Meaningful Use Objectives, Table 29: EHR Capability to Perform Stage 2 Core Set Meaningful Use Objectives among Optometrists who Reported Achieving Meaningful Use and Attesting in 2010 or 2012, Table 30: EHR Capability to Perform Stage 2 Menu Set Meaningful Use Objectives among Optometrists who Reported Achieving Meaningful Use and Attesting in 2011 or 2012, Table 31: 2014 Stage 1 Core Set Meaningful Use Objectives among Optometrists who Achieved Meaningful Use and Attested in 2013 or Plan to Achieve Meaningful Use and Attest in 2014 with CEHRT, Table 32: 2014 Stage 1 Menu Set Meaningful Use Objectives among Optometrists who Achieved Meaningful Use and Attested in 2013 or Plan to Achieve Meaningful Use and Attest in 2014 with CEHRT, Table 33: 2013 Stage 1 Core Set Meaningful Use Objectives among Optometrists who Achieved Meaningful Use and Attested in 2013 or Plan to Achieve Meaningful Use and Attest 2014 Without CEHRT, Table 34: 2013 Stage 1 Menu Set Meaningful Use Objectives among Optometrists who Achieved Meaningful Use and Attested in 2013 or Plan to Achieve Meaningful Use and Attest in 2014 Without CEHRT, Table 35: 2014 Stage 1 Core Set Meaningful Use Objectives among Optometrists without Current Plans to Achieve Meaningful Use, Table 36: 2014 Stage 1 Menu Set Meaningful Use Objectives among Optometrists without Current Plans to Achieve Meaningful Use, Table 37: Difficulties Experienced among CMS EHR Incentive Program Participants by When Attested for MU, vi
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