EHR adoption divide grows between primary care physicians and specialists

When the Centers for Medicare and Medicaid Services began the meaningful use program almost half a decade ago, the hope was that industry-wide adoption and implementation of electronic health record systems would result in a transformed health care landscape. This concept depended on health care organizations both large and small buying in to EHR systems so that the entire industry gained access to the new technology.

However, according to a recent report from the U.S. Centers for Disease Control and Prevention, EHR adoption rates among different physician groups is not even and continues to grow more disparate every year. In particular, primary care physicians use EHR systems much more often than specialists, who have lagged behind their counterparts since the beginning of the meaningful use program.

Examining the data
The CMS has done its best to incentivize EHR systems for all members of the health care industry, but the CDC report indicated that those efforts have failed to take root with certain groups of physicians.

In 2007, the respective EHR adoption rates for primary care physicians and specialists rested at 4.7 percent and 2.8 percent. The most recent data gathered for 2012 indicates that primary care physicians implemented EHR software at a high rate to push their numbers to 27.9 percent. However, specialists using the technology grew to only 19.4 percent.

Industry-wide, EHR adoption rates are high. Among office-based physicians, 71.8 percent accessed EHR systems as part of their daily workflows. These impressive figures did not influence specialists, though, who remained one of the poorest-achieving groups when it comes to EHR adoption and meaningful use compliance.

The CDC report claimed that the size of physicians' practices may point to a contributing factor for the low EHR implementation rates among specialists. EHR software is expensive, and large hospitals systems may have more resources to dedicate not only to purchasing the technology, but training staff members and ensuring compliance to meaningful use requirements for later reimbursement payments. Indeed, the CDC report noted that 97.2 percent of health maintenance organization-owned practices used EHR systems.

Specialists, who may or may not have dedicated offices and generally see fewer patients than primary care physicians, may not have the excesses revenue to throw at an EHR system.

Recommitting to EHR systems
While the low adoption rates among specialists may be concerning on their own, the consequences that the lack of EHR use among such a critical population of physicians may be even more dire. Stage 3 of meaningful use is expected to emphasize the interoperability of medical data stored in EHR systems. WIth a communicating, easily accessible network of patient information that incorporates data from multiple locations and hospital networks, proponents of the software hope that big data strategies will help uncover hidden causes of conditions and improve patient outcomes.

Without the data from specialists, the health care industry may be missing out on crucial test results that could play a critical role in the way EHR systems aid physicians' diagnoses and prescribed treatments.

However, the CDC report also explained that specialists may soon experience a dramatic increase in EHR adoption rates. One of the reasons posited by the report for low implementation rates was the lack of specialist-specific software on the market. While one type of EHR may work for all manner of primary care physicians, a dermatologist has vastly different needs than a radiologist.

However, those targeted EHR systems are being developed, and with their release, specialists may finally be able to join primary care physicians at the top of the EHR adoption ladder.