Massachusetts leads the charge in EHR adoption

The adoption of electronic health records has been sparked by federal mandates like meaningful use and the EHR incentive programs, both of which came from the U.S. Centers for Medicare and Medicaid Services. As orthopedic specialists and other physicians implement systems and increase patient engagement, one state has emerged as an industry leader.

The Bay State, long seen as the epicenter for advancements in health care, is leading the charge in EHR adoption. According to a new report from the Massachusetts eHealth Initiative, 96 percent of providers have purchased EHR software and patients are experiencing positive outcomes as a result. Fifty percent have used the programs to communicate with their primary care doctors through patient portals or other forms of online messaging, and another 78 percent feel that EHRs will help improve their care.

"Accelerating adoption of health information technology is important for Massachusetts as a model for the country," said Pamela Goldberg, CEO of the Massachusetts Technology Collaborative, quoted by the news source. "Health IT impacts health care delivery, coordination, and costs. This study shows that the Commonwealth has made significant progress with EHR and [health information exchange] adoption, and we look forward to the continuing work ahead."

Although primary care doctors have adopted EHRs at a high rate, not all specialties are at the same level. Specifically, behavioral health providers and skilled nursing facilities are lagging behind their colleagues at 55 percent, and just six out of 10 dentists use EHRs. However, 79 percent plan to adopt one within the next two years.

HIE needs more participation
Contrary to the high EHR adoption rates, HIE use within Massachusetts is relatively low. Only 26 percent of providers participated, despite the continued growth of the state-supported exchange, Mass HIway. However, doctors are optimistic that HIE participation is important to optimizing the use of EHRs in their respective facilities, as 85 percent believe that easing access to patient data is the next step after implementation.

Within the next year, 16 percent of polled physicians plan to participate in an HIE, while another 20 percent will connect with their peers or Mass HIway in the next three years. There is a clear interest in HIEs and their capabilities of improving both care quality and coordination among doctors in the Bay State.

Pressure of stage 2 regulations
Many providers are contending with the rigid standards established by stage 2 of meaningful use. According to FierceEMR, the CMS program has experienced very low numbers through the first half of 2014.

At a meeting of the Health IT Policy Committee, Elisabeth Myers, from the CMS' Office of eStandards and Services, reported that only 1 percent of providers and 3 percent of hospitals have met the stage 2 requirements of meaningful use this year. However, the federal agency was quick to point out that most attestations in previous years occurred in the third and fourth quarters.

Although it may be difficult to pinpoint one direct cause of the paltry numbers, much of the blame has shifted toward EHR vendors failing to provide properly certified products to their consumers. Without the appropriate upgrades in place, physicians cannot deliver the necessary data for attestation. In response, the CMS issued a proposed rule back in May that aimed to provide certification flexibility with existing EHR systems.

However, the language in the rule is unclear and providers need concrete timelines to maintain their momentum with meaningful use. Hopefully the agency will solidify its proposal in time for attestation rates to begin rising before the end of the reporting year.