EMR penetration not as good as it looks

Ken Terry writes on BNET Healthcare: “The latest news on electronic medical record (EMR) penetration in physician practices can be interpreted in two different ways, depending on whether you see the glass as half empty or half full. According to a 2008 survey by the Centers for Disease Control and Prevention, 38.4 percent of doctors reported they were using full or partial EMR systems, and 20.4 percent said they were using minimally functional EMRs, including e-prescribing, the ability to order tests and view lab results, and electronic notes. In a 2006 CDC survey, the corresponding figures were 29.2 percent and 12.4 percent, respectively. Optimists might cite these figures as showing that physicians are really starting to embrace EMRs.

“But not so fast. When the CDC asked about EMR systems that conform to interoperability standards and are known as electronic health records (EHRs), just 17 percent of physicians reported having basic EHRs (which do all that basic EMRs do, and can also connect with other systems in a standardized way), up from 11.2 percent in 2006. Only 4 percent of respondents said they had fully functional EHRs, compared with 3.1 percent two years earlier.

“Here’s why the answers to the EHR questions are significant: According to the Department of Health and Human Services, to which CDC belongs, an EHR is considered interoperable if it is certified by the private, nonprofit Certification Commission for Healthcare Information Technology (CCHIT). Vendors of most full-featured EHRs have had their products certified by CCHIT for competitive reasons. So physicians who report they have a “basic” EMR are probably using a low-cost or older, non-certified EMR that can’t exchange data with other systems. Even practices with “basic” EHRs may not have the tools they need to use their systems for quality improvement or care coordination.

“So if someone tells you that nearly 40 percent of doctors have EMRs, remember that only 4 percent have fully functional EHRs that can do all the good things that health reform advocates want them to do.”