Not all is sunny in Robert Wood Johnson report on health information technology

Adoption up, but EHR sophistication lags; money still a barrier to HIE
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A lot has changed since 2006, when the Robert Wood Johnson Foundation published their inagural report on Health Information Technology in the United States: The Information Base for Progress. The Office of the National Coordinator for Health Information Technology had a small budget and few hospitals had functional electronic health records, for example. 

Since then, federal support has spurred major strides in electronic health record adoption by providers, according to the 2013 Robert Wood Johnson Foundation annual report, as FierceEMR reported Monday. But a deeper look into the report shows that while providers have made significant process, there is still a way to go.

Some of the graphs accompanying the report are telling of current trends in EHR adoption--how many providers are using basic systems versus comprehensive systems as well as how many organizations are using high-level software endorsed by the government. Most, 44 percent, had "at least a basic EHR" in 2012; 27.3 percent had a step-up basic EHR in 2012, and only 16.7 percent had a comprehensive EHR.

Analyst Michael Cherny at the International Strategy & Investment Group sent a note to clients about the report, according to Forbes.

"This study shows some of the challenges with evaluating true market adoption, as it significantly lags the level of adoption seen in the CMS data on stimulus spending (where more than 80 percent of eligible hospitals have received payments for being meaningful users of EHRs)," he wrote.

"But the underlying data from this study shows the continued need to invest further in technology in order to effectively use the data contained in EHRs to drive improved health outcomes and more efficient delivery of care."

The report also offers insight on health information exchanges, finding that financial sustainability is still the biggest challenge and state and regional HIEs. Providers in large part have not been willing to pay for HIE and insurers haven't substantially supported such efforts, according to the report.

"The hope is that forces beyond HITECH will help promote HIE and create a stronger business case. In particular, new approaches to the delivery and payment of care, such as Accountable Care Organizations, could increase demand for HIE and related services," the report authors wrote.

The report offered three tips for making HIE more attractive:

  • Ensure that Stage 3 of meaningful use substantially increases requirements for HIE to increase provider demand for such capabilities
  • Better engage payers in HIE by determining what is holding them back and designing appropriate policies
  • Emphasize to states the need to identify sustainable business models. "While every state has a plan, the viability of these plans has not been rigorously assessed."

To  learn more:
- read the report

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