Over the years, electronic health records have proven their success to both health care providers and their patients. The number of practices that have adopted EHR systems increases every year.
However, meaningful use standards have made it difficult for providers to use EHRs as they struggle to meet the requirements of the EHR Incentive Programs. This challenge is reflected in the most recent data regarding meaningful use attestation figures published by the Office of the National Coordinator.
CAHs show lowest attestation numbers
Critical access hospitals, pediatricians and small physician practices are lagging behind. The ONC's data was based on information found by the network of regional extension centers in December of last year. The HealthIT.gov Quick Stats shows a large difference between the number of providers and hospitals using EHR systems and those that have attested for meaningful use.
Less than 50 percent of EHR users that participate in an REC program have been successful at demonstrating meaningful use. This is significant, as 75 percent of specialists enrolled in these programs are EHR users.
Of all the groups that have fallen behind with attestation, pediatricians and practitioners who care for adolescents are among those with the lowest figures. A total of 20 percent of them did not attest. Critical access hospitals have always ended up with lower attestation rates than other health care groups. Florida, Virginia and Hawaii are the states with the lowest rates of CAH attestation for organizations participating in REC programs, coming in at 17 percent, 20 percent and 12 percent, respectively.
"Despite major national investments to support the adoption of health IT, concerns persist that barriers are inhibiting that adoption and the use of advanced health IT capabilities in rural areas in particular," noted a recent Health Affairs study. The study suggested that the challenges experienced by CAHs are due to insufficient staffing resources and unreliable Internet connections that can make communication difficult. In fact, 30 percent of the CAHs that participated in the study reported issues with their broadband connection that interfered with EHR use.
Attestation in rural areas needs work
The most successful CAHs in the country are North Carolina, Arizona, Mississippi, Wyoming, Colorado, Vermont, Alaska and Iowa. Each state has a 100 percent attestation rate for their CAHs enrolled in REC programs.
To help less successful hospitals, regional extension centers are working with the majority of CAHs throughout the U.S. Of these CAHs, 90 percent are EHR users, yet only half have attested. Compared to their peers, CAHs have performed the worst at attesting. For example, every comprehensive primary care initiative provider in the nation is an EHR user and 80 percent of these have attested successfully.
"Maintaining and improving access to high-quality health care in rural areas has been a long-standing goal of policy makers," the Health Affairs study added. "Building and strengthening the health IT infrastructure everywhere, particularly in rural areas, is critical to improving quality and enabling delivery system transformation."
In addition to CAHs, private practices are also showing issues with meaningful use – only slightly over 60 percent of practices with over 11 doctors are EHR users, and of these, only 30 percent have attested. The meaningful use attestation milestone accomplished in 2014 took longer to achieve than the enrollment goals set for the RECs.
Now, more than 73 percent of primary care providers enrolled in REC programs have successfully achieved meaningful use. It is still difficult, however, to work with practices that have yet to take advantage of REC resources and have been unsuccessful at reaching meaningful use thresholds. To prevent providers and CAHs from falling even further behind, there is still a lot of work to be done.