Between 75-85 percent of physicians with EHRs are already using functions that meet some of the proposed criteria for demonstrating meaningful use, according to analysis from Seth O. Hogan, survey director, and Stephanie M. Kissam, health services research associate, at RTI International in Chicago.

The authors of the survey, published in the April edition of Health Affairs, said their analysis contributes new information about the rates at which primary care physicians, medical specialists and surgical specialists who had a basic EHR system used specific functions before the passage of the stimulus law, compared to the level of expected meaningful use of EHRs set forth in the proposed federal regulations.

“Among physicians who had key functions available to them, 75-85 percent reported using functions in the patient record category. These functions included organizing patient information such as sex and date of birth, lists of medications taken by the patient, problem lists or the current diagnoses of patients and clinical notes,” wrote the authors.

A stratified random sample of 5,000 U.S. office-based physicians was drawn from the American Medical Association’s Physicians Masterfile where, after 516 were determined as ineligible, 2,758 of the 4,484 eligible physicians completed the surveys during a data collection period from August 2007 to February 2008, yielding a 62 percent response rate.

The authors sorted completed interviews by whether physicians reported having a basic EHR system, meaning that it offers practitioners, at minimum, the following functions: the ability to record patient demographics, including name, address and sex, inclusion of patient problem lists, clinical notes, patient medication lists, and orders for prescriptions and electronic viewing of laboratory and imaging results. “Applying these criteria resulted in a sample of 485 physicians eligible for analysis,” the authors noted.

Fewer than one in five physicians reported having at least a basic EHR system, the survey found. Of those who did, primary care physicians were the most likely to report having a basic EHR system (19.4 percent). Medical specialists were the next group most likely to have a basic EHR system (17.1 percent) followed by surgeons (16.7 percent). “Availability of additional EHR functions, beyond those defined in a basic system, varied across all physician groups,” the authors wrote.

The use of these basic functions did not differ significantly by broad medical specialty yet the authors reported these data to provide baselines for tracking changes by specialty groups over time.

According to the survey, 79 percent of 306 responding physicians whose EHR systems had warnings for drug-to-drug interactions used this function. For information exchange functions, the authors also reported on the use of sending prescriptions electronically (79 percent of 265 respondents whose records had this function) and submitting laboratory orders electronically (used by 64 percent of 256 respondents whose records had this function).

“Public health reporting functions were less commonly used among the small number of physicians who had those functions available to them,” the authors wrote. In addition, only 27.6 percent of the 128 responding physicians said they could provide at least 10 percent of unique patients with timely electronic access to their health information, the authors found.

“To qualify for new federal funds intended to promote the widespread adoption and use of EHRs, U.S. physician practices must meet the government’s meaningful use benchmarks,” concluded the authors. “Tracking the use of EHRs across different types of providers will be a critical component in evaluating how their use affects healthcare costs, quality and safety and overall population health measures.”

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