MGMA Electronic Health Records: Status, Needs and Lessons
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- Willis Whitehead
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1 MEDICAL GROUP MANAGEMENT ASSOCIATION MGMA Electronic Health Records: Status, Needs and Lessons Report Based on Data Snapshot of an Infrastructure under Construction Special edition: Research funded by PNC Bank
2 MGMA-ACMPE is the premier association for professional administrators and leaders of medical group practices. In, members of the Medical Group management Association (MGMA), and its standardsetting division, the American College of Medical Practice Executives (ACMPE), voted to merge to form a new association. Since 96, the Association has delivered networking, professional education and resources, political advocacy and certification for medical practice professionals. The Association represents,5 members who lead, organizations nationwide in which some 8, physicians provide more than 4 percent of the healthcare services delivered in the United States. ISBN: Copyright MGMA-ACMPE. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the copyright owner.
3 Electronic Health Records: Special Edition Introduction To better understand the current state of EHR use by physicians, MGMA-ACMPE undertook a study in to explore the barriers to EHR adoption and the experiences of healthcare organizations that have progressed through the implementation process and optimized use of their EHRs. This study was funded by PNC Bank. We have taken this data and further compiled it by specialty. The following tables focus on the optimization of EHR in cardiology practices. To get the most out of these specialty tables, we recommend that you also download the free original report, Electronic Health Records: Status, Needs and Lessons.
4 Lessons - Tables Table R: For cardiology practices - Organization type Lessons - Which of the following best describes your organization? Independent medical practice Hospital or integrated delivery system (IDS) or medical practice owned by hospital or IDS Medical school faculty practice plan or academic clinical science department Federally qualified health center, community health center or similar practice Retail walk-in primary care clinic Urgent care center Freestanding ambulatory surgery center (ASC) Management services organization (MSO) Physician practice management company (PPMC) Independent practice association (IPA) Other 8.6% 8.%.%.6%.6% 4.5% 59, % 46 4.% 5.% 4.% 7.8% 5.5% 5.5% 59.7% 9.9% 45 4.%,9,5 65.8% % 48 4.% 5 4.% 7.8% 5.5% 5.5% 6.7% 9.8% 49 4.%,549 Copyright. Medical Group Management Association. All rights reserved. Page
5 Lessons - Tables Table R: For cardiology practices - Health record storage method Lessons - How does your practice currently store health record information for the majority of the practice's patients? On paper medical records and charts With a computer system where paper records and charts are scanned and filed electronically, also known as a DIMS With an electronic health record system that stores patient medical and demographic information in a computer database. I do not work for an organization that records patient health record information at the point of care. Other % 4.5% % 4.5% 59,8 7.8% 6 4.7%,87 5.% 4 4.%,9,6 7.6% %,9 5.6% 44 4.%,549 Table R: For cardiology practices - Meaningful use incentive program plans Lessons - Percent Does your practice currently plan to participate in the Centers for Medicare & Medicaid Services (CMS) EHR meaningful use incentive payment program? Yes. No, because we will not have an EHR. No, because we do not think our EHR will be certified. No, because the cost of dealing with the bureaucracy will exceed the benefits. No, because we will not have a sufficient Medicare or Medicaid population. No, for other reasons. I do not know % 4.4%.9% 4.4% 5 5.7%, ,7 7.% 5.% 4.4%.8% 4.% 9, ,5 7.6% 5.% 4.4%.7% 4.% 8.8% Copyright. Medical Group Management Association. All rights reserved. Page
6 Lessons - Tables Table R4: For cardiology practices - EHR implementation status Lessons - Which of the following best describes your practice's current EHR implementation status? We have completed an implementation and believe that our practice has optimized its use of an EHR. We have completed an implementation and are focused on optimizing our EHR. We are in the process of implementing an EHR system. We currently use an EHR and are considering implementing a different EHR. Other variation of having completed an EHR implementation or in the process of implementing an EHR. We are in the process of selecting an EHR system. We intend to implement an EHR in the next 4 months, but have not yet begun the selection process. We have no intention to implement an EHR in the next 4 months. Other variation of NOT yet beginning the EHR selection or implementation process % 6 8.4% 9.9% 7 4.4%.9%.6% 8.%.9% 7 4.4% %,87.% 5 5.4% 9 5.7% 5.7% 456.5% 4.%.6% %,9 45.7%,48.% 54 5.% % 8.6% 476.4% % 6 4.6%,549 Copyright. Medical Group Management Association. All rights reserved. Page
7 Lessons - Tables Table R5-Frequencies: For cardiology practices - As a practice that has not yet implemented an EHR, how significant are each of the following barriers to EHR implementation? Lessons - Percent Insufficient capital resources to invest in an EHR Inability to get a loan to invest in an EHR Insufficient expected return on investment from an EHR EHR security and privacy concerns Expected difficulty in integrating the EHR with practice billing system Inability of available EHR software to meet the needs of our practice specialty Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant % 7.7%.8% 8.5% 5.9% 8.%.% 9.4% 6.% 6.% 7.5% 7.5% 5.5% 7.5%.9%.4%.8% 9.8%.% 6.8% 7.% 9.% 4.4%.8%.8% 7.7% 5.6%.% % 7.7% 7 7.% 4.8% 9.% 8.% 5 8.7% 8.9% 5.%.8% 6.% 7.4% 9.% 9.4% 4.% 8.5%.6% 4.% 5.5% 6.%.4% 4.8% 5.7% 5 4.4% 8.% 6.8% , , , , ,4 4.5% 7.7% 6.8% 7.5% 4.5% 9.% 8.% 5.% 8.6% 8.8% 5.%.% 6.% 7.% 9.% 9.5% 4.% 8.%.4% 4.6% 5.7% 6.7%.5%.% 4.8% 6 5.6%.7% 8 6.7% Copyright. Medical Group Management Association. All rights reserved. Page 4
8 Lessons - Tables Table R5-Frequencies: For cardiology practices - As a practice that has not yet implemented an EHR, how significant are each of the following barriers to EHR implementation? Lessons - Insufficient time to select and implement an EHR Expected loss of productivity during transition to the EHR system Expected loss of productivity after the transition to the EHR system Reluctance of physician leadership to use an EHR Practice is considering a merger or purchase by a hospital system or another practice Expected inability to qualify for meaningful use incentive payments Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant Very insignificant Insignificant Significant Very significant % 5.5% 4 4.8% 4.8% 4 9.5% % 7.% % 4 4.5% 4.5% 9.7% 9.7%.6% 8 6.7% 6.7% 5 7.% 8 7.6% 4.8% 9 7.8%.8% 6.% 8.% 4.% % 6 6.8% % % 5 5.4% % % 4 4.4% % 99.% 4 4.4%.5% % %.6%.% 5.% % 94 7.% 7.6% 58.7% % % 65 8.% 8.8% 5.6% % 9 Based upon a 5 point scale where =Very insignificant, =Insignificant, =, 4=Significant, and 5=Very significant % % 9.8%.8% 5 4.9%,9 8.7% 55 5.% 5 4.6% % %, 9.8%.% 55 4.% 8.6%, % % 9.6%.8% 7.4%, 4.6% 7.5%.4% 66.6% 5 8.9% 57 5.% % 9.6% % 946 Copyright. Medical Group Management Association. All rights reserved. Page 5
9 Lessons - Tables Table R5-Means: For cardiology practices - As a practice that has not yet implemented an EHR, how significant are each of the following barriers to EHR implementation? Electronic Health Records: Status, Needs and Lessons - Insufficient capital resources to invest in an EHR Inability to get a loan to invest in an EHR Insufficient expected return on investment from an EHR EHR security and privacy concerns Expected difficulty in integrating the EHR with practice billing system Inability of available EHR software to meet the needs of our practice specialty Insufficient time to select and implement an EHR Expected loss of productivity during transition to the EHR system Expected loss of productivity after the transition to the EHR system Reluctance of physician leadership to use an EHR Practice is considering a merger or purchase by a hospital system or another practice Expected inability to qualify for meaningful use incentive payments Mean Mean ,7 8,4,8,,4,9,,6, Based upon a 5 point scale where =Very insignificant, =Insignificant, =, 4=Significant, and 5=Very significant Mean Copyright. Medical Group Management Association. All rights reserved. Page 6
10 Lessons - Tables Table R6-Frequencies: For cardiology practices - As a practice that has not yet selected or implemented an EHR, how helpful is the following information? Lessons - Percent How to select an EHR software vendor How to contract with an EHR vendor How to pay for the EHR How to integrate the EHR with a practice management system How to train staff and physicians How to revise practice work-flow Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful % 47.5% 5.%.6%.%.8% 5.% 5.%.6%.%.7% 47.4% 5.% 5.% 5.4% 8.% 46.% 5.5% 7.5% 7.5% 57.5% 5.5% 5 7.5% ,.5% 4.% 4.% 5.9% 4.4%.6% 4.9% 5.7%.% 4.8%.% 5.% 8.%.5% 4.8%.7% 4.% 4.% 8.% 49.7%.9% 6.6% 9.6% 58.9%.6% 7.% 8.4% 59.7% , , , , , ,4.6% 4.%.9% 5.7% 4.6%.6% 4.8% 5.5% 4.%.% 5.% 8.%.% 4.8% 4.% 4.% 8.% 49.6% 6.6% 9.5% 58.8%.%.6% 7.% 8 6.% Copyright. Medical Group Management Association. All rights reserved. Page 7
11 Lessons - Tables Table R6-Frequencies: For cardiology practices - As a practice that has not yet selected or implemented an EHR, how helpful is the following information? Lessons - How to manage change in the practice How to manage the implementation project Implementation case studies Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful Very unhelpful Unhelpful Helpful Very helpful 5.5% % 4 5.5% 7.5% 7.5% 57.5% 4 5.5% 7 7.5% % 6.6%.% % 997.% 8 8.%.% % % 4.4% % 7 7.4% 997 Based upon a 5 point scale where =Very unhelpful, =Unhelpful, =, 4=Helpful, and 5=Very helpful..% 7.6% 8.4%.% %,7 4.% 85 8.%.% %,9.9% 5.4% 6.8% 65 5.% 9 7.7%,7 Copyright. Medical Group Management Association. All rights reserved. Page 8
12 Lessons - Tables Table R6-Means: For cardiology practices - As a practice that has not yet selected or implemented an EHR, how helpful is the following information? Electronic Health Records: Status, Needs and Lessons - How to select an EHR software vendor How to contract with an EHR vendor How to pay for the EHR How to integrate the EHR with a practice management system How to train staff and physicians How to revise practice work-flow How to manage change in the practice How to manage the implementation project Implementation case studies Mean Mean , ,9,6,5,8,9,4,7,9,7 Based upon a 5 point scale where =Very unhelpful, =Unhelpful, =, 4=Helpful, and 5=Very helpful. Mean Copyright. Medical Group Management Association. All rights reserved. Page 9
13 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? A.I.med EMR By Acrendo Software, Inc. Abraxas EMR By Abraxas Medical Solutions Acumen EHR By HIT Services Group AdvancedMD EHR By AdvancedMD Agastha Medical Records (EMR) By Agastha, Inc. Agility EHR By Integritas, Inc. AllMeds EMR System By AllMeds, Inc. Allscripts Enterprise By Allscripts Allscripts MyWay By Allscripts Allscripts MyWay Reseller By Digital Efficiency Allscripts Professional EHR By Allscripts AltaPoint EMR By AltaPoint Data Systems, LLC Alteer Office By Alteer Corporation Amazing Charts By AmazingCharts.com, Inc. AmkaiCharts By Amkai, LLC Aprima Medical Software Inc. By aprimaehr ARIA Oncology Information System By Varian Medical Systems, Inc. Armed Forces Health Longitudinal Technology Application (AHLTA) athenaclinicals By athenahealth, Inc. CareRevolution By Ehs CareSeries EHR By Purkinje CareTracker EMR By Ingenix 7 6.%.9% 8 7.8%.8%.9% 6.% 7.%.%.%.5% % 5.7% 77 8.%.% 4.%.6%.5%.5%.% 4.8% 8.4% 9.4% 6.% 7.%.%.%.5% % 6.7% 85 8.% 6.%.6% 4.6%.5%.% 4.8% 8.% 9.4% Copyright. Medical Group Management Association. All rights reserved. Page
14 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? Centricity By GE Healthcare ChartCare EMR By CHARTCARE, Inc. ChartLogic EMR By ChartLogic, Inc. ChartMaker Clinical By STI Computer Services, Inc. ChartWare EMR By ChartWare, Inc. CIS EMR By P & P Data Systems, Inc. Clearpractice EMR By ClearPractice LLC CureMD EHR By CureMD Corporation d-chart EMR By NCG Medical Systems, Inc. digichart By Digichart, Inc. DocuTAP EMR and Practice Management Solution By Docutap ecast EMR By Ecast Corporation eclinicalworks By eclinicalworks eclinicalworks Reseller By GroupOne Healthsource, Inc. ecw Reseller By Gaither Technologies STC LLC EDIM By EDIMS, LLC e-mds Solution Series By E-Mds, Inc. e-medsys Electronic Health Record By PracticeOne, LLC emr4md By Mednet System Encite By Encite EncounterPRO EHR 5. By EncounterPRO Healthcare Resources, Inc. EpicCare Ambulatory EMR By Epic E-Record EMR By Exscribe, Inc. Essentris By CliniComp, Intl % 4.4% %.8%.%.%.% 7.4%.% Copyright. Medical Group Management Association. All rights reserved. Page 9.6% 4.4% %.8%.%.%.%.%.5%.%.% 7.9%.% %.7%.%.%.%.%.5%.%.% 7.8%.%.%.8%.%.%.% 7.%.%
15 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? EyeDoc EMR By Penn Medical Informatics Systems, Inc. ezemrxprivate By Outsource Inc. GEMMS ONE G.7 By GEMMS ggastro By Gmed, Inc. gloemr By Glostream, Inc. Healthland Healthmatic A4 by Allscripts HealthPort EMR V9. By Healthport HemOncPro By MedSym, Inc. Horizon Ambulatory Care By McKesson iknowmed By US Oncology Intergy EHR by Sage By Sage Software KeyChart By KeyMedical Software, Inc. MacPractice MD By MacPractice, Inc. MaximEyes By First Insight Corporation MED InteGreat EHR By MED, Inc. MedAppz isuite By MedAppz, LLC Medenet EMR By Medenet, Inc. MEDENT By Community Computer Service Inc. Medflow EMR By Medflow, Inc. Medformix By Crowell Systems Medical and Practice Management (MPM) By Lss Data Systems Medical Manager by Sage Software Medicat By Medicat, LLC.4%.9% 5 4.4% 4.5%.8%.%.%.5%.%.5% 7.% 54.5%.%.%.% 6.7% 7.% 9.4% 8.8% 4.% 6.%.% 5.7%.5%.%.5% 7.% 59.6%.%.%.% 6.7%.% 9.4%.% 8.8% 4.% 6.% Copyright. Medical Group Management Association. All rights reserved. Page
16 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? MedicsDocAssistant By Advanced Data Systems Corporation Medi-EMR By Medi- EMR, LLC MedInformatix By MedInformatix, Inc. MediNotes by Allscripts Medisoft Clinical EMR By Practice Convergence Medisoft Clinical Reseller By Microwize Technology, Inc. MediSYS EHR By MediSYS for Physicians, Inc. MedServices By DataNet Solutions, Inc. meridianemr By Meridianemr, Inc. MicroMD EMR By Henry Schein Medical Systems, Inc. Millennium PowerChart/Power Works EMR By Cerner Corporation Misys EMR by Allscripts Mosaiq By ELEKTA IMPAC SOFTWARE NetPractice EHR By Noteworthy Medical Systems, Inc. NetPracticeEHRweb By Noteworthy Medical Systems, Inc. nextemr By nextemr NextGen Ambulatory EHR By NextGen Healthcare Nightingale On- Demand By Nightingale Informatix Corporation Office Practicum By Connexin Software, Inc. OfficeEMR 8 By Isalus Healthcare OncoEMR By Altos Solutions.9%.8%.9%.6% 4.%.6%.5%.%.% 7.% 7.% 5.4% 7.7% 9.4% 5.% 6.7% 5.4%.% 8.4% 4.% 5.7%.5%.%.% 7.% 7.% 5.% 8.6% 9.4% 5.% 9.8% 74.9%.% 8.% 4.% Copyright. Medical Group Management Association. All rights reserved. Page
17 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? OpenVista By Medsphere Systems Corporation OrthoPad By Stryker Patient Chart Manager By Prime Clinical Systems, Inc. PBSI-EMR By Positive Business Solutions, Inc. PeakPractice By Eclipsys Practice Solutions PeakPractice Reseller By Bond Medical Physician Care Manager By Meditech PowerSoftMD By Data Tec, Inc. Practice By NexTech Systems, Inc. Practice Fusion EHR By Practice Fusion Practice Partner EMR Reseller By Practice Convergence Practice Partner By Practice Partner/McKesson Corporation PRAXIS EMR V4. By Infor*Med, Inc. PRAXIS EMR Version 5 By Infor*Med, Inc. PrimeSuite By Greenway Medical Technologies PRO EMR By MD Synergy Solutions, LLC. PrognoCIS By BizMatics, Inc. Pronto By Clinical Insight Systems, Inc. Pulse Patient Relationship Management (Pulse PRM) By Pulse Systems, Inc. Raintree By Raintree Systems, Inc. Sage Intergy EHR By Sage Software.9% 4.5%.8% 4.%.%.% 6.% 55.5% 4.%.% 7.%.% 7.%.5% 4.%.% 4.% 6.% 55.4% 4.%.% 76.%.% 7.% 4.5% Copyright. Medical Group Management Association. All rights reserved. Page 4
18 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? SamNotes By ICS Software, Ltd. SequelMed EMR 7.5 By Sequel Systems, Inc. Sevocity By Sevocity, a division of Conceptual MindWorks, Inc. Sigmund By Sigmund Software, LLC SmartClinic By VIP Medicine, LLC SOAPware By SOAPware, Inc. SpringCharts EHR By Spring Medical Systems, Inc. SRS Hybrid EMR v7 By SRSsoft SSIMED EMRge By SSIMED, LLC STIX EHR By Integritas, Inc. StreamlineMD By ProPractica, Inc. SuiteMed Intelligent Medical Software By SuiteMed, LLC Sunrise Ambulatory Care By Eclipsys SYSTOC By Occupational Health Research Team Chart Concept By Ulrich Medical Concepts, Inc. UroChartEHR By Intuitive Medical Software, LLC Visionary DREAM EHR 7. By Visionary Medical Systems, Inc. vxvista V. By Document Storage Systems, Inc. Waiting Room Solutions Practice Management System By Waiting Room Solutions Waiting Room Solutions Reseller FL By Stimulus Medical LLC.8% 5.% 5.%.% 5.7%.% 5.%.% 4.% 4.% 5.% 5.%.% 7.7%.% 5.%.% 4.% 4.% Copyright. Medical Group Management Association. All rights reserved. Page 5
19 Lessons - Tables Table R7: For cardiology practices - EHR system name Lessons - What is the name of your current EHR system? Webchart EMR and MIE Minimally Invasive EMR By MIE - Medical Informatics Engineering XpressChartsEHR By XPress Technologies ZipChart EMR By ZipChart Other 4.5% 4 4.%.% 8 8.%,9 4.%.% 84 8,7 Table R8: For cardiology practices - EHR system type Lessons - What best describes your practice's current EHR system design? Self-contained system operating on computers integral to the practice or health system that the practice belongs to Application Service Provider (ASP) system where vendor operates server and practice accesses EHR through internet Other 86.% 5.9%.9% 6,688 7.% 54.5% 75.%,4, % %,4 Copyright. Medical Group Management Association. All rights reserved. Page 6
20 Lessons - Tables Table R9: For cardiology practices - EHR service and support method Lessons - How is your EHR software serviced and supported? The EHR software vendor provides most of the software service and support. We outsource most of the EHR software service and support to an outside entity. Practice staff provides most of the EHR software service and support. Some combination of the above options Other %.% 4 4.5%.6% 6, 4.8% 4.9% 5 5.% 754.7% 78.4%,6,6 4.8% % 8.%,4 Table R: For cardiology practices - EHR and PMS integration method Lessons - Which of the following best describes how your EHR is integrated with your practice management system (PMS)? The EHR and PMS are stand alone systems with no functional integration. The EHR and PMS are from different vendors and we had to buy or develop an interface. The EHR and PMS are from a single vendor and are integrated. Other 4.4% 8.6% 86.%.7% % 59.%, % 95 4.%, %, % 97 4,4 Copyright. Medical Group Management Association. All rights reserved. Page 7
21 Lessons - Tables Table R: For cardiology practices - EHR utilization rates Lessons - Percent What percentage of the physicians in your practice currently use your EHR system? Zero % % to 5% 6% to 5% 5% to 75% 76% to 99% % I do not know %.9%.7%.9% % ,45, 8.% 5.%.8% 5.8%.4% 6.7%.9% ,54,49 8.5% 4.9%.7% 5.6%.% 6.4%.9% Table R: For cardiology practices - How did you train your physicians and staff to use your EHR? Lessons - We sent selected Yes 7.6% % % physicians and staff offsite No 5 6.4% %,7 59.5% to receive training. 85,64,79 We trained selected Yes %,7 77.9%, % staff to train the No 4 5.% 88.% 4.7% remaining staff. 9,758,85 Yes 6 7.6%, 7.%,74 7.% We used self-training materials. No 7.4% % % 84,587,67 We received on-site Yes %,695 88,78 88 training while keeping No.% 4 the office open. 99,96,5 We received on-site Yes % training while keeping No 66 88,69 7,5 7.7% the office closed. 75,465,54 We received on-site Yes 6 66.%,59 68.%, 68.% training while reducing No.7% 54.8% 57.9% patient visit loads. 9,7,79 We trained during time periods (such as nights Yes 6.8% 57.8% 5.8% and weekends) when No 5 66.% %,45 66.% the office was normally closed. 77,5,578 We used web-based Yes 5 6.7%,44 69.%, % and online training No 9.% 56.7% 59.% resources. 84,65,74 Yes 7.8% % Other No 6 7.% % Copyright. Medical Group Management Association. All rights reserved. Page 8
22 Lessons - Tables Table R: For cardiology practices - Time allocated for EHR training Lessons - Which of the following best describes the time allocated for training physicians and staff how to use your EHR system? We severely underallocated time for training. We mildly underallocated time for training. We properly allocated time for training. We mildly overallocated time for training. We severely overallocated time for training. Other.% 4 7.4% 5 4.5%.9%.9% 7 6.% 5.4% 9 9.8% 8 5.5% 44.9% 9.4% 8.9%,6 6.% % % 45.9%.4% 9 8.8%,76 Copyright. Medical Group Management Association. All rights reserved. Page 9
23 Lessons - Tables Table R4: For cardiology practices - What methods do your practice physicians use to enter data into your EHR? Lessons - Percent Fixed location computer or terminal Portable computer that can be moved from room to room Keyboard Mouse Touchscreen Voice recognition software Use a staff member (a scribe) ipad Smartphone device Other Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No % 7.% 9.5% 7.5% 4.% 57.8% % 5.% 5.% 74.7% 8.% 9.9% 5.4% 84.6%,67 7,944,575 8,956,79 9,88,7 7, , , ,48 88,87,75 8,79, % 9.5% 95.% 4.8% 94.% 5.8% 5.4% 49.6% 55.5% 44.5% 8 6.7% 86.%.% 86.7%.4% 78.6%,76 84,44,647 45,5,88 98,979,88 4,9 8 8, , ,559 7,4,45 87,47, %.9% 8.% 9.7% % 5.9% % 44.4% 8.5% 6.5% 4.% 85.7% Copyright. Medical Group Management Association. All rights reserved. Page
24 Lessons - Tables Table R5: For cardiology practices - EHR financing method? Lessons - What was the primary method that your practice used to pay for your EHR? From the business' cash reserves From the personal cash reserves of the providers Business loan Personal loan(s) Business lease Personal lease(s) Subsidized by hospital, integrated delivery system, or other parent organization Other 5.% %.9% 8 6.9%.%.6% 6 74.% % % 5.9% %,6 759.% 47.9% % % 54.% 98 8.%,4 Table R6: For cardiology practices - EHR capital and operating costs Electronic Health Records: Status, Needs and Lessons - EHR capital cost per FTE physician (dollars) EHR operating cost per FTE physician per month (dollars) Mean 56,4,5 Std Dev 7,84,557 Mode 4, 5 5th %tile,66 59 Median 4, 75 75th %tile 74,67, Table R6: For cardiology practices - EHR capital and operating costs Electronic Health Records: Status, Needs and Lessons - EHR capital cost per FTE physician (dollars) EHR operating cost per FTE physician per month (dollars) Mean 9,4,64 Std Dev Mode 5th %tile 49,94 5, 5,, Median 7, th %tile 45,, Copyright. Medical Group Management Association. All rights reserved. Page
25 Lessons - Tables Table R6: For cardiology practices - EHR capital and operating costs Electronic Health Records: Status, Needs and Lessons - EHR capital cost per FTE physician (dollars) EHR operating cost per FTE physician per month (dollars) Mean 4,94,9 Std Dev 5,99,88 Mode 5, 5 5th %tile 6, 9 Median, 55 75th %tile 48,,5 What was the total purchase cost for your EHR system (software, hardware, cabling, telecommunications upgrades, building modifications, training, etc.) divided by your practice's number of full-time equivalent (FTE) physicians? What is the approximate software and hardware maintenance cost per FTE physician per month for your current EHR system? (If you use an ASP model EHR, report your monthly cost per FTE physician.) Copyright. Medical Group Management Association. All rights reserved. Page
26 Lessons - Tables Table R7-Frequencies: For cardiology practices - How satisfied are you with the following aspects of your practice's EHR experience? Lessons - Percent Your overall EHR system Your EHR software service and support The integration of your EHR and practice management system (PMS) Your EHR training experience The ability of the EHR to increase the quality of patient care The ability of the EHR to enhance patient safety Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied % 7.5% 4.% 44.%.% 4.9%.7% 8.4% 4.7%.% 4.9% 6.8%.7% 7.9% 9.8% 5.7%.%.7% 4.6% 9.8%.8%.%.5% 8.% 5.%.8% 8.7% 4 4.%.% , , , , , , % 4.% 4.9% 9.8% 7.4% 4.% 8.% 8.%.% 6.9%.% 4.%.6% 6.% 5.5% 4.7%.5% 9 7.% 4.5% 7.9%.9% 6.7% 9.5% 6.7%.8% 8.5% 8.6% , , , , , ,8 4.9% 9.% 4.% 4 9.8% 7.% 4 8.% 8.%.% 6.8%.% 4.9% 6.% 5.5% 4.6%.5% 9 7.4% 4.4% 8.%.9% 6.7% 8.8%.5% 6.8%.9% 8.7% 8.% Copyright. Medical Group Management Association. All rights reserved. Page
27 Lessons - Tables Table R7-Frequencies: For cardiology practices - How satisfied are you with the following aspects of your practice's EHR experience? Lessons - The ability of the EHR to increase patient satisfaction The ability of the EHR to decrease practice costs The ability of the EHR to increase practice revenue The ability of the EHR to increase provider productivity Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied Very unsatisfied Unsatisfied Satisfied Very satisfied 8 7.%.8% 7 5.6% 6 5.4% % 9 7.4% 6 4.5% 7 5.5% % 5.8% 8 6.7% 8 6.7% 7 6.% 5.% 6 4.5%.7% 7 5.5% % % 76 4.% 695.6% %, % 54 7.% 699.8% % 7 4.9%, % % % % 7 5.4%,57 55.% 4 9.% 6 9.9% % 7,86 Based upon a 5 point scale where =Very unsatisfied, =Unsatisfied, =, 4=Satisfied, and 5=Very satisfied % 9 8.9% % 4 9.%, % 8 7.6% 75.4% % 4 4.9%, % 4.9% % % 4 5.4%,6 67.% % % % 89.%,9 Copyright. Medical Group Management Association. All rights reserved. Page 4
28 Lessons - Tables Table R7-Means: For cardiology practices - How satisfied are you with the following aspects of your practice's EHR experience? Electronic Health Records: Status, Needs and Lessons - Your overall EHR system Your EHR software service and support The integration of your EHR and practice management system (PMS) Your EHR training experience The ability of the EHR to increase the quality of patient care The ability of the EHR to enhance patient safety The ability of the EHR to increase patient satisfaction The ability of the EHR to decrease practice costs The ability of the EHR to increase practice revenue The ability of the EHR to increase provider productivity Mean Mean,4,,54,94,89,78,67,67,57, ,,,57,,96,8,7,7,6,9 Mean Based upon a 5 point scale where =Very unsatisfied, =Unsatisfied, =, 4=Satisfied, and 5=Very satisfied Copyright. Medical Group Management Association. All rights reserved. Page 5
29 Lessons - Tables Table R8: For cardiology practices - For each of the 5 meaningful use core objectives, which option best describes your practice's CURRENT status relative to the objective? Lessons - The EHR supports computerized physician order entry (CPOE) for medication orders. The EHR can implement drug-drug and drug-allergy checks. The EHR supports e- prescribing (erx) by generating and transmitting permissible prescriptions electronically. The EHR can record and store patient demographics. feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other %.6% 8 7.% % 4.5% 6 5.4% % 8 7.% 4.5% 8 7.% % 6 5.4%.9% 5 4.5%,7 77.6% 6 9.% 5.6% %,8, % 6 7.4% 56 7.% %,, % 4.8% 57 7.% 5.5%,,6 9.9% 5.% %,5, % 8 9.4% 5.6% %,, % % %,5, % 48.7% 6 6.9% 9 5.5%,5,5 9.8% 57.5% 45.9% 89.8%,6 Copyright. Medical Group Management Association. All rights reserved. Page 6
30 Lessons - Tables Table R8: For cardiology practices - For each of the 5 meaningful use core objectives, which option best describes your practice's CURRENT status relative to the objective? Lessons - The EHR can maintain an up-to-date problem list of current and active diagnoses. The EHR can maintain an active medication list. The EHR can maintain an active medication allergy list. The EHR can record and chart changes in patient vital signs. feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other % 5 4.4%.8% 7 6.% 88.5% 4.5%.8% 7 6.% % 6 5.4%.8% 8.9% 94 8.% 7 6.% 5 4.4% 7 6.%, % 4.5% %,6,4 9.% 5.4% 8.% 95 4.%,6,9 9.% 57.6%.5% 7 4.9%,5,87 8.4% 8 5.8% 9 4.% %,6,7 88.9% 5 4.5% %,9,4 9.9% 57.4%.% 4.4%,9, 9.8% 6.7% 4.5% 7 5,7,9 8.4% 5 5.8% 98 4.% %,9 Copyright. Medical Group Management Association. All rights reserved. Page 7
31 Lessons - Tables Table R8: For cardiology practices - For each of the 5 meaningful use core objectives, which option best describes your practice's CURRENT status relative to the objective? Lessons - The EHR can record smoking status for patients years old and older. The EHR can implement clinical decision support rules relevant to the practice's specialties and track compliance with the rules. The EHR can report ambulatory clinical quality measures to the CMS or the states. The EHR can provide patients with an electronic copy of their health information upon request. feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other % 4.6% 8.9% 4 8.4% 8.8%.5% 5.% % % 7.4% % 5.%.4%.6%, % 5 6.8% 4 6.4% 5.4%, % 4 8.8% 96 8.% 48, % % % 64 9,86,9 6.% 8 4.5% 67.% 67.%,9, % % 44 6.% 6.%, % 4 8.8% 49 8.% 56, % % %,99,4 6.9% 4.5% 9.6% 79.%,4 Copyright. Medical Group Management Association. All rights reserved. Page 8
32 Lessons - Tables Table R8: For cardiology practices - For each of the 5 meaningful use core objectives, which option best describes your practice's CURRENT status relative to the objective? Lessons - The EHR can provide patients with a clinical summary of each office visit. The EHR has the capability to electronically exchange key clinical information among providers and patient authorized entities outside of our practice. The EHR uses certified EHR technology to protect electronic health information. feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other feature and all or some of our physicians use it feature but none of our physicians use it Our EHR does not have this feature Not applicable to our scope of practice, do not know, or other % 5.%.6%.6% 4 5.4% 8.6% 9.% 9 6.8% 8 7.4% 7 6.% %,9 6.8% 4 8.% 9.7% 48.%, 94 4.% 57 6.% 489.% 99 8.%,88, % 7.% 5.9% 5.5%,,4 6.6% % 5 9.7% 6.%, % % 5.7% 48 8.%,, % %, Copyright. Medical Group Management Association. All rights reserved. Page 9
33 Lessons - Tables Table R9: For cardiology practices - EHR impact on operating cost Lessons - Allowing enough time Increased 6.6% 66 7.% % after implementation for physicians and staff to Stayed the same 7.5% % % become familiar with Decreased 6.% % 44 8.% the EHR, what happened to total Not applicable or do 8 4.6% 66 9.% practice operating not know costs? 4,58,7 Table R: For cardiology practices - EHR impact on productivity Lessons - Percent Allowing enough time after implementation for physicians and staff to become familiar with the EHR, what happened to physician productivity? Increased Stayed the same Decreased Not applicable or do not know %.4% 6.% 5.7% ,9.9% 4.9% 4.6% 9.6% ,54.% 4.7% 4.7% 9.4% Copyright. Medical Group Management Association. All rights reserved. Page
34 Lessons - Tables Table R: For cardiology practices - Lessons - What best describes your practice type? Multispecialty with primary and specialty care Multispecialty with primary care only Multispecialty with specialty care only Allergy / Immunology Anesthesiology Anesthesiology: Pain Management Critical Care: Intensivist Dentistry Dermatology Dermatology: Mohs Surgery Emergency Medicine Endocrinology / Metabolism Family Practice Gastroenterology Genetics Geriatrics Hematology / Oncology Hospitalist Infectious Disease Internal Medicine Neonatal Medicine Nephrology Neurology OB/GYN OB/GYN: Gynecological Oncology OB/GYN: Maternal / Fetal Medicine OB/GYN: Reproductive / Endocrinology Occupational Medicine Ophthalmology Ophthalmology: Retina Orthopedic surgery Otorhinolaryngology %.9%.5%.9% 7.% 47.4%.%.% 5.5%.4% 7.5%.6% 9.6% 84.5% 4.4% 67.6% 7.5% 7.%.%.9% 4.% 8 5.% 9.% 4.4%.% 7.% 85.5% 9.6% 6.6% 77.% 78.%.7%.4%.9% 7 47.% %.%.% 5.5%.% 7.5%.6% % 4.4% 67.9%.6% 7.5% 7.%.8% 4.% 8 5.% 9.% 4.4%.% 7.% 85.4% 9.5% 6.% 77.% Copyright. Medical Group Management Association. All rights reserved. Page
35 Lessons - Tables Table R: For cardiology practices - Lessons - Percent What best describes your practice type? Pathology Pediatrics Pediatrics: Pediatrics: Child Development Pediatrics: Critical Care / Intensivist Pediatrics: Endocrinology Pediatrics: Gastroenterology Pediatrics: Hematology / Oncology Pediatrics: Hospitalist Pediatrics: Nephrology Pediatrics: Pulmonology Physiatry Podiatry Psychiatry Pulmonary Medicine Radiation Oncology Radiology Rheumatology Surgery: Cardiovascular Surgery: Colon and Rectal Surgery: General Surgery: Neurological Surgery: Oncology Surgery: Oral Surgery: Pediatric Surgery: Plastic / Reconstructive Surgery: Trauma Surgery: Vascular Urgent Care Urology Other Organization is not a medical practice ,9.% 5.%.%.%.%.6%.8%.8%.%.%.5%.6%.%.%.7%.%.%.%.5%.%.5%.%.%.6%.4% ,549.% 4.8%.%.%.%.%.5%.7%.8%.%.%.5%.6%.%.%.6%.%.%.%.5%.%.5%.%.5%.% Copyright. Medical Group Management Association. All rights reserved. Page
36 Lessons - Tables Table R: For cardiology practices - FTE physicians Electronic Health Records: Status, Needs and Lessons - How many full-time equivalent (FTE) physicians work for your medical practice? What percentage of your practice's physicians are over the age of 5? Mean 4 4 Std Dev 7 Mode 5 5 5th %tile 5 Median th %tile 5 59 Table R: For cardiology practices - FTE physicians Electronic Health Records: Status, Needs and Lessons - How many full-time equivalent (FTE) physicians work for your medical practice? What percentage of your practice's physicians are over the age of 5?,7,79 Mean 6 7 Std Dev Mode 5th %tile Median th %tile 5 Table R: For cardiology practices - FTE physicians Electronic Health Records: Status, Needs and Lessons - How many full-time equivalent (FTE) physicians work for your medical practice? What percentage of your practice's physicians are over the age of 5?,48,99 Mean 5 8 Std Dev 8 Mode 5 5th %tile Median th %tile 9 5 Copyright. Medical Group Management Association. All rights reserved. Page
37 Lessons - Tables Table R: For cardiology practices - Number of FTE physicians category Lessons - Percent How many full-time equivalent (FTE) physicians work for your medical practice? Less than FTE to 5 FTE 6 to FTE to 5 FTE 6 to 5 FTE 5 FTE or more %.% 8.% 6.9% 7.7%.% 8, ,7.9% 9.4% 6.7% 7.%.7% 4, ,48 9.7%.8% 9.8% 7.% 7.%.% Table R4: For cardiology practices - Percentage of physicians over the age of fifty Lessons - Percent What percentage of your practice's physicians are over the age of 5? Less than % % to 5% 6% to 5% 5% to % %.9%.9% 8.% ,79.% 8.9% 5.7%.% ,99.9% 8.6% 6.4% Copyright. Medical Group Management Association. All rights reserved. Page 4
38 Lessons - Tables Table R5: For cardiology practices - State Lessons - Percent In which state is your practice located? Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina % 5.%.9% 5.%.%.6% 6.%.%.6%.8% 5.7%.9%.6%.%.9%.6%.6% 9.5%.5%.%.6%.%.6%.8%.% 5.%.9%.%.5% %.7%.7%.% 6.%.5%.4%.%.% 5.5%.%.%.%.8%.7%.%.%.%.%.7% 4.%.%.5%.%.5%.5%.7%.7%.8% 4.%.8%.% 4.%.7% 4.4%.% %.6%.8%.% 6.%.4%.%.%.% 5.6%.%.%.%.8%.8%.%.%.%.%.7%.9%.9% 4.4%.%.5%.%.5%.9%.5%.7%.7%.8% 4.%.7%.% 4.%.7%.9%.4%.% Copyright. Medical Group Management Association. All rights reserved. Page 5
39 Lessons - Tables Table R5: For cardiology practices - State Lessons - Percent In which state is your practice located? South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming %.% 9.5%.9%.9%.6%.% ,55.%.7% 6.8%.8%.4%.%.4%.4%.6%.4% ,5.%.7% 6.9%.8%.4%.%.4%.4%.6%.% Table R6: For cardiology practices - MGMA membership status Lessons - MGMA membership status National MGMA member State MGMA member Neither national nor state MGMA member MGMA membership status unknown 99 6.% % 4 8.8% 59, % 7 44.%,9, % % 48.%,549 Copyright. Medical Group Management Association. All rights reserved. Page 6
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