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Statewide Implementation of Electronic Health Records

Statewide Implementation of Electronic Health Records. EHRs in Massachusetts: Who has them and how are they using them? Supported by the Agency for Healthcare Research and Quality. Outline. Background: Massachusetts e-Health Collaborative Two statewide surveys Office practice managers

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Statewide Implementation of Electronic Health Records

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  1. Statewide Implementation of Electronic Health Records • EHRs in Massachusetts: Who has them and how are they using them? • Supported by the • Agency for Healthcare Research and Quality © 2006 Steven R. Simon, MD All Rights Reserved

  2. Outline • Background: Massachusetts e-Health Collaborative • Two statewide surveys • Office practice managers • Physicians in office practices © 2006 Steven R. Simon, MD All Rights Reserved

  3. Massachusetts e-Health Collaborative (MAeHC) • Formed in 2004 • Major health care stakeholders • $50 million from Blue Cross Blue Shield of MA • Statewide EHR adoption • Demonstration project: • Universal EHR adoption in 3 communities • Intra-community and inter-community data exchange © 2006 Steven R. Simon, MD All Rights Reserved

  4. EHR Adoption in U.S., 2003 • Most physicians do not currently use EHRs • National average 17.6% of physicians using EHRs • Large groups more likely to use EHRs than small groups • HMO-owned practices are three times more likely than physician-owned practices to use an EHR * Burt and Sisk. Health Affairs. Sep/Oct 2005. © 2006 Steven R. Simon, MD All Rights Reserved

  5. What is Current State of EHR Adoption in Massachusetts? • Two statewide surveys, summer 2005 • Office practice managers • Physicians in office practices © 2006 Steven R. Simon, MD All Rights Reserved

  6. Office Practice Survey • Stratified sample of 1829 practices • (30% of state) • All specialties, urban/rural, large and small practices • 1-page mailed survey sent to the attention of office practice managers • 46% response rate © 2006 Steven R. Simon, MD All Rights Reserved

  7. © 2006 Steven R. Simon, MD All Rights Reserved

  8. Implementation – Future Plans Within the next 12 months (13%) Not in the foreseeable future (52%) Within the next 1-2 years (24%) Within 3-5 years (11%) © 2006 Steven R. Simon, MD All Rights Reserved

  9. Barriers to Implementation* © 2006 Steven R. Simon, MD All Rights Reserved

  10. Physician Survey Same sample of practices as office manager survey Included only physicians with ambulatory clinical practices 8-page mail survey $20 incentive © 2006 Steven R. Simon, MD All Rights Reserved

  11. Overall Response Rate: 71% © 2006 Steven R. Simon, MD All Rights Reserved

  12. EHR Adoption © 2006 Steven R. Simon, MD All Rights Reserved

  13. EHR Adoption © 2006 Steven R. Simon, MD All Rights Reserved

  14. Incentives Moderate/Extensive Yes Percent with EHR Yes No Limited/None No © 2006 Steven R. Simon, MD All Rights Reserved

  15. Additional Adoption Statistics • On a physician level, a total of 45 percent of physicians in Massachusetts had EHRs. • Among practices with EHRs, more than half (53 percent) reported having EHRs in their practice for more than 3 years. © 2006 Steven R. Simon, MD All Rights Reserved

  16. Practice characteristics as correlates of EHR Adoption © 2006 Steven R. Simon, MD All Rights Reserved

  17. Office computing capabilities as correlates of EHR adoption in ambulatory care © 2006 Steven R. Simon, MD All Rights Reserved

  18. Perceived barriers to adoption or expansion of HIT as correlates of EHR adoption in ambulatory care © 2006 Steven R. Simon, MD All Rights Reserved

  19. Organizations influencing practices in the decision whether to adopt a new EHR system © 2006 Steven R. Simon, MD All Rights Reserved

  20. Limitations • Massachusetts only • New measure of EHR usage (may not be comparable to other studies) • Cross-sectional: difficult to draw causal inference © 2006 Steven R. Simon, MD All Rights Reserved

  21. Conclusions • Fewer than one in four office practices in MA have EHRs • Nearly 50% of physicians in MA have EHR in their practice • Larger practices and hospital-based practices were more highly correlated with EHR adoption © 2006 Steven R. Simon, MD All Rights Reserved

  22. Conclusions (2) • For practices without EHRs, >80% report finances as major barrier • Both financial and non-financial (e.g., cultural) barriers persist • EHR decision-making is local  Implications for interventions © 2006 Steven R. Simon, MD All Rights Reserved

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