According to the Health Information Technology for Economic and Clinical Health Act (HITECH), providers and hospitals who demonstrate the meaningful use of a certified electronic health record (EHR) system, are eligible for incentive payments.
The meaningful use programs seemed to have worked well, with office based physician EHR use jumping from 67.5% in 2013 to 74.1% in 2014. However, the same cannot be said for the sharing of patient data amongst the users of EHR and outside providers. From 2013 to 2014, data sharing grew by 32.5% for certified EHR users and 26% amongst all providers.
EHR adoption
According to the CDC report, a certified EHR is one that meets the criteria laid down under the Centers for Medicare & Medicaid Services EHR Incentive programs. The report states that office based EHR adoption and use was fairly ubiquitous from state to state. Most states showed EHR adoption at around 70% with a few low adapting states like Alaska which hovered around 58%. Adoption rates in states like Iowa, Oregon, North Carolina, South Dakota, Vermont and Minnesota ranged in the low to mid 80%. Overall, the increase in office based EHR adoption was across all states.
Patient data sharing
As stated by the CDC report, patient data sharing did not show the same growth rates as EHR adoption and use. The report highlights the extent to which providers used EHR data to share with outside providers. Only a handful of states stood out for high rates of patient data sharing. While New Jersey rated lower than the national average, states like Oregon, North Dakota, Massachusetts and Washington had data sharing rates higher than the national average. Internal data sharing was more standardized across all providers, with data sharing between providers within a practice hovering around 15%. The report also showed that certain kinds of data were shared more easily than others. Certified EHR users shared patient data regarding long term care, behavioral health and home health more frequently than other data.
Requirements of Stage 2 Meaningful Use
A significant requirement of Stage 2 Meaningful Use for eligible professionals (EPs) is the sharing of electronic data. The three requirements for EPs to qualify for Meaningful Use Stage 2 are:
- Provide summary of care for 50% of transitions of care or referrals.
- The summaries are to be provided through electronic exchange on certified EHR technology or through a health information exchange approved by the Office of the National Coordinator of Health IT.
- At least one electronic message should be sent successfully to a provider with a different EHR vendor.
However, the report shows that the very first requirement has proven to be difficult. With a score of barely 40%, communicating between EHRs proved to be difficult for the majority of providers. While the number of providers using certified EHR technology showed a marked increase, the number of them sharing patient data electronically was dismally low.
The total percentage of certified EHR users exchanging patient information electronically stood at 32% with barely 15% patient data exchange between providers at the same healthcare organization. These figures are disappointing to say the least. With the EHR meaningful program moving ahead towards Stage 3, providers will find it difficult to qualify for the incentive payments. Healthcare providers have a huge challenge ahead of them if they are to comply with the attestations.
Electronic sharing of patient data will have to keep pace with adoption and use of the electronic health record systems for the program to be successful.
