News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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Survey of EMR Adoption by Doctors Provides “Best Data There’s Ever Been!”

It’s tough to get an accurate picture of EMR (electronic medical record) adoption by office-based physicians. That’s important information for clinical laboratories because they must often provide an electronic gateway interface with physicians’ EMR systems for laboratory test ordering and results reporting.

Now comes help for clinical laboratories and pathology groups seeking to understand the pace of EMR adoption by physicians. This summer, The Institute for Health Policy published the results of a six-month study on the use of electronic health records (EHRs) in physicians’ offices in the New England Journal of Medicine. “This is the best data that there has ever been on the adoption of electronic health records by physicians,” said William Jessee, M.D., the physician president and chief executive officer of the Medical Group Management Association.

According to the abstract of the NEJM article, 4% of physicians reported having an extensive, fully-functional electronic-records system, and 13% reported having a basic system. Another finding was that the physicians most likely to be currently using EMRs were: 1) primary care physicians; 2) those physicians practicing in large groups, in hospitals or medical centers; and, 3) physicians practicing in the western region of the United States. Physicians reported positive effects of these systems on several dimensions of quality of care, as well as high levels of satisfaction in how their system performed. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.

The survey was conducted between September 2007 and March 2008 at the 902-bed Massachusetts General Hospital, Boston; the Harvard School of Public Health; George Washington University; and RTI International, working under a contract with the Office of the National Coordinator for Health Information Technology at HHS and grants from the Robert Wood Johnson Foundation.

Despite the fact that the survey revealed that 83% of physicians don’t have an EHR, the NEJM authors pointed out some good news. They noted that 16% of physicians with no EHR responded that their medical practice had purchased an EHR at the time of the survey, but it had yet to be implemented. Another 26 % of surveyed physicians said their practice was planning on implementing an EMR system in the next two years.

The conclusions of the report were that “Physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems. However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. physicians, who may differ from later adopters of these systems.”

The pace and nature of physician adoption and use of EHRs are important issues for medical laboratories and pathology labs. Lab managers and pathologists will want to be ahead of physician EHR adoption curve by preparing their laboratory information system (LIS) to interface with these EHRS to accept electronic test orders and directly download lab test results into the physician’s HER system.

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Slow EHR Adoption from Doctors Affects E-Connectivity of Labs

Only one in four physicians, or 24.9%, currently uses some sort of electronic health record (EHR) under the loosest possible definition of the term. That’s the finding in a recent study entitled Health Information Technology in the United States: The Information Base for Progress performed by the Robert Wood Johnson Foundation and the federal government’s health information technology office. Of greater interest, only about 10% of physicians use a “fully operational” system, or a system that collects patient information, shows test results, and allows providers to enter medical orders and prescriptions.

The report’s findings are useful for laboratory administrators and pathologists because they demonstrate that implementation and use of EHRs by office-based physicians remains in its early stages. That gives laboratories and pathology group practices more time to craft an effective EHR strategy

We are pitifully behind where we should be,” said David Bumenthal, a co-author of the report. His words have certainly impacted the medical community. Google “EHR Adoption Pitifully Behind” , and you will discover that Bumenthal’s comment has been picked up by numerous media outlets. Most everyone finds this study newsworthy and discouraging. The government realizes that, with doctors continuing to use EHRs at their current rate, they will not hit President Bush’s goal to ensure that most Americans have their medical information collected, stored, and organized electronically by 2014. Healthcare-savvy patients will also be frustrated to know that doctors are so slow to adopt EHRs, as they certainly realize that electronic medical records lead to fewer handwriting errors and fewer resulting medical diagnosis and prescription errors.

Why do EHR adoption rates by physicians remain low? The study hypothesizes that financial, technical, and legal barriers are to blame. Furthermore, there is no standard definition of what constitutions an EHR. Modern Healthcare Magazine quotes Providence Health System doctor Dick Gibson as saying that “Most docs who do it [use EHRs] say they do it because it’s the right thing to do. We know that the patient gets most of the benefits, the health plans get the rest, and the doctor is the one who has to pay for it.”

Lab directors and pathologists should keep in mind that this report on EHR adoption fails to make a key point: The larger the physician group, the more likely it is to have already implemented an effective EHR or EMR (electronic medical records) system. Thus, it is these physician groups and clinics which are larger in size – and important laboratory customers – that are first to go electronic with their medical records. To build and maintain competitive advantage, progressive laboratories and pathology group practices should already have a strategy and a solution that allows their laboratory to interface with the physicians’ EHR system for electronic test orders and lab test reporting.


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