MEDICAL GROUP MANAGEMENT ASSOCIATION MGMA Electronic Health Records: Status, Needs and Lessons Report Based on Data Snapshot of an Infrastructure under Construction Special edition: Obstetrics/ Research funded by PNC Bank
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, members who lead, organizations nationwide in which some 8, physicians provide more than percent of the healthcare services delivered in the United States. ISBN: 978--689-- 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.
Electronic Health Records: Special Obstetrics/ 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 obstetrics/gynecology 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.
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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 8 8.%.%.8%.6%.7%.7%,87 6.9% 67 6.8%.%.%.% 7.8%.%.% 7.7% 9.9% 6.%,69, 6.8% 87 6.% 8.%.% 7.8%.%.% 6.7% 9.8% 9.%,9 Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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 66 7 8 6.7%.8% 6.7%.9%,7 7.7% 6.7%,8.% 7.%,69,6 7.6% 6.6%,9.6%.%,9 Table U: For obstetrics / gynecology practices - Meaningful use incentive program plans Lessons - 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. 9 9 8 6.7%.7%.7%.%.8%, 68 7 8 6 89, 7.%.%.%.%.% 8.6%,6 77 6 9, 7.6%.%.%.7%.% 8.8% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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 months, but have not yet begun the selection process. We have no intention to implement an EHR in the next months. Other variation of NOT yet beginning the EHR selection or implementation process. 6 7 9 8 6.7%.% 6.7%.7% 8.9%.8% 8.%,9.% 8.% 87.6%.7% 6.7% 7 9.7%.6%.%,69.7%,8.%.% 99.6% 8.6% 76.%.% 6.6%,9 Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U-Frequencies: For obstetrics / gynecology practices - As a practice that has not yet implemented an EHR, how significant are each of the following barriers to EHR implementation? 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 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 6 8 6 9 6 6 7 7 7.%.8%.% 8.%.% 8.%.% 8.%.8%.%.%.8%.6%.6% 9.6%.8%.%.% 9.6%.6% 9.%.% 8.%.% 8.%.% 9.% 8.8%.% 76 6 6 96 6 7 7 66 7 78 7 9 6 7 9 9 7 6 6 97 7 97 98 7 68 6 9.% 7.9% 6.9% 7.%.6% 8.6% 9 8.% 8.9%.9%.% 6.% 7.% 8.6% 9.%.% 8.%.6%.%.% 6.%.6%.%.%.6%.%.% 8.% 7.% 6 78 7 8,7 7 89 7 7 8 6 7 9, 96 8 6 7,8 8 69 7 7, 6 7 8 8 68,.% 7.7% 6.8% 7.%.% 9.% 8.%.% 8.6% 8.8%.%.% 6.% 7.% 9.% 9.%.% 8.%.%.6%.7% 6.7%.%.%.8% 6.6%.7% 8 6.7% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U-Frequencies: For obstetrics / gynecology 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 6.% 8.% 7.% 6.% 6.%.9%.8% 6.% 8.% 9.7%.7%.7%.9% 9.% 7.% 8.% 7.%.% 6.9%.% 8.%.% 7.%.% 6.9% 9 8 7.6% 9.8% 9 9.%.% 7 7 6 8 9 96 7 979 9 96 6 98 69 7 98 6 96 8 97 6 9 7 6 79 8 899 7.% 6.8% 9.7%.9%.%.8%.%.8%.9%.%.%.%.7% 7.%.7%.6%.%.% 7.9%.%.6% 9.9% 7.9%.8%.% 78 69,9 8 7, 8,6 77 8 9 7, 66 7 66 9 9 96 Based upon a point scale where =Very insignificant, =Insignificant, =, =Significant, and =Very significant. 7.7% 6.7% 9.8%.8%.9%.7%.%.6%.6%.7% 9.8%.%.%.6% 7.6%.6%.6%.8%.%.6% 7.%.%.6% 8.9%.% 7.%.6%.8% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U-Means: For obstetrics / gynecology 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 9 9 7.8..7.6.8.6...87..7. 78 9 97 98 9 96 979 98 96 899 Mean.6.6.9..6.9.8.8.8..,7 8,,8,,,9,,6, Based upon a point scale where =Very insignificant, =Insignificant, =, =Significant, and =Very significant. 96.98 7 96 Mean.98.6.6.9...8.9.8.7.. Copyright. Medical Group Management Association. All rights reserved. Page 6
Lessons - Obstetrics/ Tables Table U6-Frequencies: For obstetrics / gynecology practices - As a practice that has not yet selected or implemented an EHR, how helpful is the following information? 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 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 6 8 9 8 9 9 9.8% 7.7% 9.6% 9.% 9.6% 8 6.9%.9% 7.6%.7% 6.9%.8% 7.7%.8%.% 9.6%.6%.6%.6% 6.% 7.7%.6%.8%.% 8.% 7.9% 8 7 7 977 7 966 9 7 96 9 9 7 69 96 9 9 67 98 7 98 6 7 8 86 98.6%.%.% 6.%.7%.%.9%.6%.6%.%.%.% 8.%.%.7%.%.6% 8.6% 9.%.9%.9% 6.8%.% 8.6% 7.% 8.% 9.% 7 67 8,9 7 9 7 8,6 8, 8 8,8 69 7 6,9 7 7 9 6,.6%.%.9%.7%.6%.6%.8%.%.%.%.% 8.%.%.8%.%.% 8.% 9.6% 6.6% 9.% 8.8%.%.6% 7.% 8 6.% Copyright. Medical Group Management Association. All rights reserved. Page 7
Lessons - Obstetrics/ Tables Table U6-Frequencies: For obstetrics / gynecology 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.7%.9% 9.%.9% 9.%.6%.6%.% 6 66.7%.7%.7% 8.% 9.% 8.9% 6 8 6 98 8 98 8 6 6 7 98.%.6%.%.%.%.%.% 8.%.6%.8%.8%.%.% 7.6% Based upon a point scale where =Very unhelpful, =Unhelpful, =, =Helpful, and =Very helpful..% 7.6% 8.%.% 8.9%,7.% 8 8.%.% 86 6.%,9.9%.% 6.8% 6.% 9 7.7%,7 Copyright. Medical Group Management Association. All rights reserved. Page 8
Lessons - Obstetrics/ Tables Table U6-Means: For obstetrics / gynecology 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...6...... 977 966 9 96 98 98 98 98 98 Mean.9.7...9..6..,9,6,,8,9,,7,9,7 Based upon a point scale where =Very unhelpful, =Unhelpful, =, =Helpful, and =Very helpful. Mean.9.7..6.9..6.. Copyright. Medical Group Management Association. All rights reserved. Page 9
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology 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.9% 8.6%.9%.7% 7 6 9 8.7% 8.%.%.%.6%.%.%.8%.% 6 8 6 8 Copyright. Medical Group Management Association. All rights reserved. Page.7%.9%.% 6.%.%.%.% 6.9% 6 7 6.%.%.%.%.% 6.8%.7% 8.%.%.6%.6%.%.%.8%.%
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? CareTracker EMR By Ingenix 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 emrmd By Mednet System Encite By Encite EncounterPRO EHR. By EncounterPRO Healthcare Resources, Inc. EpicCare Ambulatory EMR By Epic 9 6.% 6 7.% 68 7.% Copyright. Medical Group Management Association. All rights reserved. Page 7.8%.%.%.7% 9 9 7 7 6 7.% 8.7%.8%.%.%.%.%.%.% 7.9%.%.%.8%.%.%.% 9 7 79 6 7.% 8.7%.7%.%.%.%.%.%.%.% 7.8%.%.%.8%.%.%.%
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? E-Record EMR By Exscribe, Inc. Essentris By CliniComp, Intl. 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 A 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.9%.7%.%.%.7%.%.%.% 7.% 9.7%.%.%.% 6.7% 9.% 9.%.%.%.%.7%.%.%.% 7.% 9.6%.%.%.% 6.7%.% 9.%.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? Medical and Practice Management (MPM) By Lss Data Systems Medical Manager by Sage Software Medicat By Medicat, LLC 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 7.9%.%.9%.%.9% 6 8.8%.% 6.%.%.%.%.% 7.% 7.%.%.6% 9.%.% 8.8% 67.% 8.8%.% 6.%.7%.%.%.% 7.% 7.%.% 8.6% 9.%.% 9.8% 7.9% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? Nightingale On- Demand By Nightingale Informatix Corporation Office Practicum By Connexin Software, Inc. OfficeEMR 8 By Isalus Healthcare OncoEMR By Altos Solutions 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 V. By Infor*Med, Inc. PRAXIS EMR Version By Infor*Med, Inc. PrimeSuite By Greenway Medical Technologies PRO EMR By MD Synergy Solutions, LLC. PrognoCIS By BizMatics, Inc. 7.%.% Copyright. Medical Group Management Association. All rights reserved. Page.9%.9%.6%.% 8 9.%.%.%.%.%.%.%.%.%.%.% 8 6 76.%.%.%.%.%.%.%.%.%.%.%
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? 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 SamNotes By ICS Software, Ltd. SequelMed EMR 7. 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. Copyright. Medical Group Management Association. All rights reserved. Page.7%.%.9% 6.%.%.%.%.%.7%.%.%.%.%.% 7 7.%.%.%.%.%.7%.%.%.%.%.%
Lessons - Obstetrics/ Tables Table U7: For obstetrics / gynecology practices - EHR system name Lessons - What is the name of your current EHR system? 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 Webchart EMR and MIE Minimally Invasive EMR By MIE - Medical Informatics Engineering XpressChartsEHR By XPress Technologies ZipChart EMR By ZipChart Other 6.%.% 8 8.%,9.%.% 8 8,7 Table U8: For obstetrics / gynecology 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 8 9 6.6%.%,78 7.% 7.% 7.%,98,788 7.9% 6 76.%, Copyright. Medical Group Management Association. All rights reserved. Page 6
Lessons - Obstetrics/ Tables Table U9: For obstetrics / gynecology 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 7 6.%.% 8.9%.%.% 987.9% 8.%.% 76.% 78.%,99,6.8% 6 79.8% 8.%, Table U: For obstetrics / gynecology 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 9.% 7.9% 7.8%.% 6 7.% 7.6%, 66.% 9,87 69 7 9.%,6 66.6% 97, Copyright. Medical Group Management Association. All rights reserved. Page 7
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - EHR utilization rates Lessons - What percentage of the physicians in your practice currently use your EHR system? Zero % % to % 6% to % % to 7% 76% to 99% % I do not know. 6.%.%.8%.9%.% 8.% 89 9,,6 8.8%.9%.9%.6%.% 6.%.9% 7 8 9 7,,9 8.%.9%.7%.6%.% 6.%.9% Copyright. Medical Group Management Association. All rights reserved. Page 8
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - How did you train your physicians and staff to use your EHR? Lessons - We sent selected physicians and staff offsite to receive training. We trained selected staff to train the remaining staff. We used self-training materials. We received on-site training while keeping the office open. We received on-site training while keeping the office closed. We received on-site training while reducing patient visit loads. We trained during time periods (such as nights and weekends) when the office was normally closed. We used web-based and online training resources. Other Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No 86 68 7 9 8 87 99 8 6 78 7 9 8 6 9 9 8 8 6 7.% 6.8% 7.6% 8.% 6.% 6.% 87.9%.%.% 76.9% 68.9%.% 6.% 7.8% 67.8%.%.% 77.8% 66 96,6,8 7,7, 66,86,696,96 87,7,6,9,689 986,98,,6 8 8.7% 9.% 78.6%.% 7.6% 9.% 88.%.9% 6.% 7.% 68.% 6.8% 69 7.% 6.6% 69,7,79,8,8,7 97,67,78,,,, 7,79,,78,9 9,7 89.% 9.% 78.%.7% 7.% 9.7% 88 6.% 7.7% 68.%.9%.8% 66.% 68.9%.% 6.% 6.7% Copyright. Medical Group Management Association. All rights reserved. Page 9
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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.7%.8% 6.%.8%.6% 9.% 89 9.6% 88.8% 8.% 98 8.8%, 6.% 9 9.7% 8.9%.9%.% 9 8.8%,76 Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - What methods do your practice physicians use to enter data into your EHR? Lessons - 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 86 96 6 9 9 99 8 7 8 9 7 7 7 7 7 6 7 6 7 6 8.%.9% 9.6% 9.% 9 9.9%.% 6.%.%.7% 7.% 77 9.9% 9.%.% 8.9%.% 86.7%,67 69,9, 9,96,786 9,879,7 9,8 78 79,76 98 7,69 8 9,8,79,79 77,86,6 7 86.%.8% 79.7%.% 9.%.9% 9.%.9% 9.6%.% 7 9.% 6.7%.% 8.% 87.% 78.6%,76 8,,67,,88 98,979,88,9 8 8,66 97 76,7 6 99,9 7,, 87,7, 7 77 6 86.%.9% 8.% 9.7% 9 9.%.9%.6%.% 8.% 6.%.% 8.7% 87 79 Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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 8 6.8%.8% 7.%.8% 8.9%.%.% 76.% 6 66 7.% 6.7% 8.9% 9 8.%,9 79.% 7.9% 69 8.% 66 6.8%.% 98 8.%, Table U6: For obstetrics / gynecology 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) 8 Mean,6, Std Dev Mode th %tile,7,,,6 8 Median 8,7 68 7th %tile,, Table U6: For obstetrics / gynecology 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) 669 76 Mean,6, Std Dev Mode th %tile,8,,,9 8 Median 9,777 7th %tile,, Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U6: For obstetrics / gynecology 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) 77 77 Mean,9,9 Std Dev,99,88 Mode, th %tile 6, 9 Median, 7th %tile 8,, 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
Lessons - Obstetrics/ Tables Table U7-Frequencies: For obstetrics / gynecology practices - How satisfied are you with the following aspects of your practice's EHR experience? 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 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 6 8 8 7 7 6 8 6.%.% 9.% 8.6%.6% 7 9.6% 8.%.%.9% 8.8% 7.% 7.%.6%.% 8.% 9.8% 8.% 8.%.%.%.9% 6.8% 6.%.%.%.6%.% 9.% 97 9 888 6,6 99 8 797 68,98 7 9 8 678 76, 8 87 6,86 9 67 76 6,8 7 6 8 8,69.8% 9.%.% 9.7% 7.%.% 8.% 8.% 6.7%.%.9%.% 6.%.%.% 9.6% 7.%.% 8.9% 6.7% 9.% 7.% 9.% 8.% 9 6 9 66, 6 88 9, 7 7 79 78,7 6 89 8, 97 79 8 87 6,96 76 8 99 8 6,8.9% 9.%.% 9.8% 7.% 8.% 8.%.% 6.8%.%.9% 6.%.%.6%.% 9 7.%.% 8.%.9% 6.7% 8.8%.% 6.8%.9% 8.7% 8.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U7-Frequencies: For obstetrics / gynecology 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.6% 9.9% 6.% 7.9% 9 7.% 9 8 8.8% 9.8% 9.9%.%.7%.6% 9.8% 9.%.%.% 9 7 9.%.%.7% 8 8 69 7,6 96 6 686 7,6 9 76 9, 6 7 77,8.% 8.8%.6% 9.% 9.% 7.6%.%.6% 7.6%.%.% 6.%.6%.% 9.7% 9.%.%.% Based upon a point scale where =Very unsatisfied, =Unsatisfied, =, =Satisfied, and =Very satisfied. 88 9 78 7,7 8 7 6,7 67 76 7,6 67 9 66 6 89,9.% 8.9%.7% 9.% 9.% 7.6%.%.7%.9% 7.7%.9%.% 6.%.%.% 9.6% 9.%.6%.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U7-Means: For obstetrics / gynecology 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.8.6.86.6.7.78..6..,6,98,,86,8,69,6,6,,8 Mean.8..8.9.78.8.6.8.7.8,,,7,,96,8,7,7,6,9 Mean Based upon a point scale where =Very unsatisfied, =Unsatisfied, =, =Satisfied, and =Very satisfied..8..8.8.77.8..8.7.8 Copyright. Medical Group Management Association. All rights reserved. Page 6
Lessons - Obstetrics/ Tables Table U8: For obstetrics / gynecology practices - For each of the 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 9 9 6 6 7 9 96 6 9 8 6 8 86.6%.%.% 7.6% 8.9% 8.7%.%.%.% 9.%.8%.%.%,69 76.9% 9.7% 8.8% 66 7.%,,69 77 7 7.8% 6 7.% 77 8.%,96,69 76.7%.% 7 7.% 6.7%,6,7 9.8% 6.% 9.8% 86.9%,98,797 77.% 8 9.%.6% 7 7.%,,79 77.% 77 7.6% 6 7 8 7.9%,,787 76.9% 8.7% 6 6.9% 9.%,, 9.8% 7.%.9% 89.8%,6 Copyright. Medical Group Management Association. All rights reserved. Page 7
Lessons - Obstetrics/ Tables Table U8: For obstetrics / gynecology practices - For each of the 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 9 9 9 6 6 9.%.%.8%.% 9.8%.8%.8%.% 9.%.%.7%.% 88.8%.%.%.6%,96 88.7%.% 6.%.7%,,6 9.7% 6.% 9.% 99.%,,99 9.7% 6.7%.%.%,98,88 8.% 9.9% 9.% 7 7.8%,,7 88.9%.% 7 7.6%,9, 9.9% 7.%.%.%,9, 9.8% 6.7%.% 7,7,9 8.%.8% 98.% 7 7.%,9 Copyright. Medical Group Management Association. All rights reserved. Page 8
Lessons - Obstetrics/ Tables Table U8: For obstetrics / gynecology practices - For each of the 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 9 7 8 9 9 6 8 7 6 79.9% 8.% 6.7% 9.8% 9.8% 6.% 9.7% 8.6% 7.8%.9% 6.7%.%.9%.%,66 7.6% 8 6.7% 6.%.%,9 89.8% 9 8.7% 96 8.% 87.%,8 79 6.%.6% 9.% 6 8.7%,8,7 6.6% 9.6% 7.6% 67.%,88,7 7.8% 6.7% 6.% 6.%, 9.9% 8.8% 9 8.% 6,98 87 6 6.8% 9.% 66 8.9%,99, 6.9%.% 9.6% 79.%, Copyright. Medical Group Management Association. All rights reserved. Page 9
Lessons - Obstetrics/ Tables Table U8: For obstetrics / gynecology practices - For each of the 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 8 7 9 9 9 8 9 7 67.%.%.9% 7.6% 6.6%.6% 7.8% 86.%.6%.% 7.7%, 6.% 9 8.6% 9.7%.%,9 98.% 6 6.7% 9.6% 97 8.%,8,77 78.6% 7.% 6.% 6.8%,96, 6.6% 6 8.% 9.7% 6.%, 98.7% 78 6.%.7% 8 8.%,,88 79 77.% 9 6 69.6%, Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U9: For obstetrics / gynecology practices - EHR impact on operating cost Lessons - Allowing enough time Increased 6.% 6 7.6% 6 7.% after implementation for physicians and staff to Stayed the same 6.9% 6.% 97.% become familiar with Decreased 7.7% 7 8.% 8.% the EHR, what happened to total Not applicable or do 9.% 66 9.% 689 9 practice operating not know costs? 9,,7 Table U: For obstetrics / gynecology practices - EHR impact on productivity Lessons - 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 8 8 8 6.9%.7% 7.%.% 8 768 9 9,6.%.%.6% 9.6% 86 8 7,.%.7%.7% 9.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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 Cardiology Critical Care: Intensivist Dentistry Dermatology Dermatology: Mohs Surgery Emergency Medicine Endocrinology / Metabolism Family medicine Gastroenterology Genetics Geriatrics Hematology / Oncology Hospitalist Infectious Disease Internal medicine Neonatal Medicine Nephrology Neurology : Gynecological Oncology : Maternal / Fetal Medicine : Reproductive / Endocrinology Occupational Medicine Ophthalmology 8 7.% 7.% Copyright. Medical Group Management Association. All rights reserved. 8.% 8.% Page 78 7 7 9 7 9 8 67 7 7 9.%.9%.6%.9%.%.%.7%.%.%.%.%.%.6%.6%.%.%.6%.%.%.%.9%.%.%.%.% 78 7 7 9 7 9 8 67 7 7 8 9.%.7%.%.9%.%.%.%.%.%.%.%.6%.%.%.9%.6%.%.%.8%.%.%.%.%.%
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - Lessons - Ophthalmology: Retina 9.6% 9.% Orthopedic surgery 6.6% 6.% Otorhinolaryngology 77.% 77.% Pathology 8.% 8.% Pediatrics 7.% 7.8% Pediatrics: Cardiology 6.% 6.% Pediatrics: Child Development Pediatrics: Critical Care / Intensivist.%.% Pediatrics: Endocrinology.%.% Pediatrics: Gastroenterology Pediatrics: Hematology / Oncology Pediatrics: Hospitalist Pediatrics: Nephrology.%.% Pediatrics: Pulmonology Physiatry 9.6% 9.% What best describes Podiatry 6.8% 6.7% your practice type? Psychiatry 8.8% 8.8% Pulmonary Medicine 8.% 8.% Radiation Oncology.%.% Radiology 8.% 8.% Rheumatology.6%.6% Surgery: Cardiovascular 8.% 8.% Surgery: Colon and Rectal 9.% 9.% Surgery: General 9.8% 9.6% Surgery: Neurological Surgery: Oncology.%.% Surgery: Oral.%.% Surgery: Pediatric.%.% Surgery: Plastic / Reconstructive 8.% 8.% Surgery: Trauma.%.% Surgery: Vascular 8.% 8.% Urgent Care 7.% 7 Urology 79.% 79.% Other 87.6% 87.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - Lessons - What best describes your practice type? Organization is not a medical practice 8 7.%,69 7.%,9 Table U: For obstetrics / gynecology 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? 78 Mean 9 Std Dev Mode th %tile 6 Median 7th %tile 9 Table U: For obstetrics / gynecology 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?,,788 Mean 6 8 Std Dev Mode th %tile 8 Median 7 7 7th %tile Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology 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?,8,99 Mean 8 Std Dev 8 Mode th %tile Median 7 7th %tile 9 Table U: For obstetrics / gynecology practices - Number of FTE physicians category Lessons - How many full-time equivalent (FTE) physicians work for your medical practice? Less than FTE to FTE 6 to FTE to FTE 6 to FTE FTE or more 7 6 6 6 78.%.%.% 9.%.8%,8 6 7, 9.7%.% 9.% 7.6% 7.%.8%,7 678 88,8 9.7%.8% 9.8% 7.% 7.%.% Table U: For obstetrics / gynecology practices - age of physicians over the age of fifty Lessons - What percentage of your practice's physicians are over the age of? Less than % % to % 6% to % % to % 6.%.%.%.% 9 79 7 669,788.% 8.% 6.% 6 8 76 689,99.9% 8.6% 6.% Copyright. Medical Group Management Association. All rights reserved. Page
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - State Lessons - Alabama 7.9% 8.% 9.6% Alaska.7%.6% Arizona 7.9% 9.8%.8% Arkansas.6%.% 6.% California 7.% 7 6.% 6.% Colorado 6.% 8.% 86.% Connecticut.%.% 7.% Delaware 8.% 8.% District of Columbia 9.% 9.% Florida 8.% 88.6% 96.6% Georgia 6.% 7.% 8.% Hawaii 8.% 8.% Idaho.6%.%.% Illinois 8.%.7%.8% Indiana 6.% 9.8% 99.8% Iowa.%.% Kansas.8%.% Kentucky.7% 76.% 79.% Louisiana.%.%.% Maine.6%.7%.7% In which state is your practice located? Maryland 67 67.9% Massachusetts.% 66 68.9% Michigan 9 7.% 6.% Minnesota.%.% Mississippi.6% 6.% 7.% Missouri.8% 7.% 76.% Montana.6% 7.% 8.% Nebraska.% 6.9% 68.9% Nevada.% 6.% 8.% New Hampshire.6%.7%.7% New Jersey.% 9.8% 96.7% New Mexico.6% 7.8% 8.8% New York 6.%.% 9.% North Carolina 7.% 8.%.7% North Dakota.%.% Ohio 6.%.% 6.% Oklahoma.% Oregon 6.% 88.6% 9.7% Pennsylvania.6% 8.8% 8.9% Copyright. Medical Group Management Rhode Island Association. All rights reserved..%.% Page 6 South Carolina.7%.%.%
Lessons - Obstetrics/ Tables Table U: For obstetrics / gynecology practices - State Lessons - In which state is your practice located? South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 8 79.% 6.%.6%.%.8% 7 7 7 78 7,.%.6% 7.8%.%.%.%.%.7%.% 7 9 8 7 8 7,.%.7% 6.9%.8%.%.%.%.%.6%.% Table U6: For obstetrics / gynecology practices - MGMA membership status Lessons - MGMA membership status National MGMA member State MGMA member Neither national nor state MGMA member MGMA membership status unknown 97 8.9%.%.8%.%,867.% 69.% 6.%,69,96.% 7.6% 8.%,9 Copyright. Medical Group Management Association. All rights reserved. Page 7
Electronic Health Records: Status, Needs and Lessons Report Based on Data Snapshot of an Infrastructure under Construction Special edition: Obstetrics/ MGMA-ACMPE Inverness Terrace East Englewood, CO 8 877.7.66 Mgma.com Research funded by PNC Bank