EMR use still low at solo and small practices

But adoption rates at practices with more than 10 physicians have grown significantly since 2009.

By Pamela Lewis Dolan, amednews staff. Posted March 11, 2010.

A recent survey of 180,000 physician offices conducted by the health care marketing research firm SK&A found overall EMR use to be at about 36%, a three-percentage point increase over 2009.

But for practices of 10 physicians or more, the growth rate was much faster. For offices with between 11 and 25 physicians, the adoption rate went from 39% to 65%. And for practices with 26 or more doctors, growth was 39% to 71%. Growth was due mostly to larger groups rolling out their systems to more of their physicians, SK&A said.

Jack Schember, vice president of marketing for SK&A, said because of the 2009 stimulus package -- which promises up to $44,000 per physician in incentive pay for EMR use -- researchers thought the overall growth rate from a year ago would be about 5% to 7%. But there seems to be a lack of understanding about EMRs and how to choose the best system, he said. And choosing the wrong system could disqualify a practice from receiving incentive money.

To qualify for the incentive, EMR systems must meet certain criteria for meaningful use, standards the Dept. of Health and Human Services did not release until December 2009. HHS is hearing public comments on the interim final rule until March 12.

Many small practices have been reluctant to invest before knowing what those requirements would be, analysts said.

The survey found that only 29% of solo practices and 37% of two-physician practices use an EMR.

In addition to large practices, those owned by larger hospitals or health systems also are more likely than practices not owned by hospitals to have EMRs. The survey found that 50% of health system-owned practices and 44% of hospital-owned practices use EMRs. Comparatively, 34% of practices not owned by hospitals and 34% of practices not owned by health systems use EMRs. Schember said this is likely because the larger systems are better funded and also have IT staff that help practices make the decision on what system to buy.

SK&A's survey results followed those released by the Centers for Disease Control and Prevention's National Center for Health Statistics. The CDC estimated that 44% of doctors are using a full or partial EMR, with most of those using partial systems. Those numbers were based on data provided by 5,200 office-based physician practices.

The SK&A survey didn't separate fully functional EMRs from partial systems, but it did ask about the use of three particular functions: electronic note taking; electronic prescribing; and electronic lab and x-ray reports. It found that only 22% of doctors were using all three of those basic functions.

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