Electronic Medical Records: Slow but Steady Growth in Ambulatory Care

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CHICAGO — Market growth of electronic medical record implementations in ambulatory healthcare settings, such as private medical practices or specialty clinics, continues at a slow but steady pace, according to results from the Ambulatory Healthcare IT Survey, conducted by the Healthcare Information and Management System Society (HIMSS) and HIMSS Analytics. The 2008 survey collected information about key technology use in the ambulatory market, such as EMRs and e-prescribing.

Approximately one-third of respondents noted that functional components of an electronic medical record are in place at their organization. While some respondents mentioned use of specific EMR software brands at their organizations, the research clearly suggests that no dominant market leader exists, and instead, many software vendors are players in this market.

“The survey results show some purchasing hesitation among physicians who don’t yet have an EMR,” said Mike Davis executive vice president of HIMSS Analytics. “We found that cost continues to be a significant barrier to technology implementation, despite the benefits of improved patient care and fewer medical errors attributed to the EMR.”

The HIMSS/HIMSS Analytics Ambulatory Healthcare IT Survey also found that:

  • Market growth is predicted to be slow with just 13 percent of respondents indicating that they will purchase an EMR in the near future.
  • Half of these respondents said that their organization will purchase an EMR application within a year.
  • Among both current and future users, physician charting/documentation and nursing charting/documentation were key features that are/will be used.

Other key survey findings from HIMSS/HIMSS Analytics include:

Billing: Three-quarters of respondents handle the billing at their practice internally; another 20 percent use a billing service.

Practice Management System: Approximately three-quarters of respondents indicated that a practice management system is in place at their facility.

Barrier to EMR Adoption: Cost and lack of interest in EMR systems were identified as the two top barriers to adopting EMR technology.

CCHIT Certification: Half of respondents that plan to purchase an EMR indicated that they will purchase a system that is certified by the Certification Commission of Healthcare Information Technology (CCHIT).

E-prescribing: One-quarter of respondents reported that their organization uses e-prescribing technology. The majority of respondents that do not use this technology reported that their organization has no plans to purchase e-prescribing technology in the future.

Information on HIT: Over half of the respondents reported that they do not attend trade shows to get information on HIT.

The overall results of the HIMSS/HIMSS Analytics Ambulatory Health IT survey are similar to “Electronic Health Records in Ambulatory Care—A National Survey of Physicians,” which appeared in the July 3 issue of the New England Journal of Medicine. With a grant from the Office of the National Coordinator of Healthcare IT, the Institute for Health Policy conducted the survey to measure EMR adoption rates among physicians in ambulatory care settings. This survey indicated that only a “small minority of U.S. physicians” had adopted electronic systems as of early 2008. Physicians that do use the EMR confirm that the technology improves the “quality of care” and are “generally satisfied” with the technology.

HIMSS Analytics conducted the telephone survey in June 2008 with 500 individuals, usually the practice managers at ambulatory practices. The respondents included three practice-size categories: 54 percent were small practices with one to three full-time employees (equivalents); 37 percent were medium practices with four to 14 FTEs; and 9 percent were large practices with 15 or more FTEs. In addition, one-third of the respondents worked for a primary care practice with the remaining two-thirds employed at a specialty clinic.

“Our survey results indicate that medical practices and clinics recognize both the value of, and the barriers to, implementation of the electronic medical record,” said Mary Griskewicz, MS, FHIMSS, senior director, ambulatory information systems, HIMSS. “While this transition from paper to digital health records slowly moves ahead in ambulatory healthcare settings, HIMSS will continue to monitor the needs of, and provide educational resources, for this important sector of healthcare.”

Source: Healthcare Information and Management System Society and HIMSS Analytics

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