Electronic Health Reporter

So, we’ve finally done it – we’ve reached the sticking point in the battle of electronic health records. Apparently, as of April 2013, more than half of all office-based physicians and other eligible professionals received their meaningful use incentive payments for successfully using and adopting EHRs.

Which means … you guessed it – more than 50 percent of eligible professionals successfully used a certified EHR (of course the number is higher if you calculate the number of physicians not using a certified system).

According to Modern Healthcare, in April 191,305 physicians and EPs received EHR incentive payments from Medicare, and 88,903 have received payments from Medicaid and 11,117 from Medicare Advantage under programs created by the American Recovery and Reinvestment Act of 2009.

In January, CMS said 527,200 were eligible for payment; 55 percent of all eligible physicians have now received some form of EHR incentive payment. More than 99,000 EPs have registered with the Medicare or Medicaid programs but have not yet been paid. Medicare and Medicare Advantage eligible physicians include physicians, optometrists, podiatrists, chiropractors and dentists. Medicaid eligible physicians are physicians, dentists, physician assistants, nurse practitioners and certified nurse-midwifes. (Okay, enough of the fine print.)

Also through April, 3,880 hospitals have received incentive payments from either Medicare or Medicaid, or both, sharing more than $8.7 billion in ARRA funds. The CMS earlier estimated that 5,011 hospitals were eligible for the programs, which puts the current payment rate at 77.4 percent. (Combined, the EP and hospital programs have paid out just over $14.6 billion.)

However, while this is interesting and probably great news, there’s an another side to the story, according to Michael Lake, president of Circle Square, which publishes a monthly overview of most of the prominent news in the HIT.

According to Lake, who quotes an AmericanEHR study, physician satisfaction in electronic health records has fallen over the last few years. Specifically, “Primary care physicians were generally more satisfied with EMR than specialists.”

Apparently, 15 percent more physicians are more dissatisfied with their system than they were in 2010. Compared to 2010, when 19 percent of users were very disappointed with their EHR, with 2012 when 34 percent are very dissatisfied.

Also eye opening is that clinicians “who won’t recommend an EMR to colleagues also saw a 15 point rise to 39 percent,” according to Lake.

Reasons include:

• Inappropriate products selected for their style of practice, particularly in specialty practices
• Employers selecting solutions without physician buy-in

Further explanation by AmericanEHR suggests that impacts of EHR on productivity, there is increased complexity as EHRs include “new features that clinicians must use to get federal incentives” and “productivity hasn’t returned as promised after adoption of EHRs; they are cumbersome even when learned.”

Another fact of higher use of EHRs, as pointed out by Software Advice, is that 30 percent of EHR decisions in 2013 are to replace a current EHR, up 50 percent from 2010.

“Top reasons for replacing the EHR include:

• Dissatisfied with current EHR > 60%
• Want a fully integrated system < 20%
• Old or unsupported system < 20%
• Cost implications < 15%
• Compliance with meaningful use < 15%

I’ll leave it up to you to draw your own conclusions, but it seems pretty obvious to me that either the complaints about the ease of use of EHRs are correct, meaningful use is making the use of EHRs more cumbersome than in the past or a combination of both.