EMR Adoption: Starting to Evolve or Still Stuck in the Past?

Gienna Shaw, for HealthLeaders Media , February 23, 2010

But Spencer notes that physicians who've been practicing for 20 or 30 years won't see a big productivity boost because they are already close to maximum efficiency. And they're already seeing patients for the shortest amount of time possible before patients start looking elsewhere for care.

Although adoption in mid- to large-size organizations is moving steadily forward, small and rural hospitals, obviously, still struggle with the financial piece. HITECH and its promise of stimulus dollars has helped overcome some of those concerns. But Patrick O'Hare, senior VP and CIO at Spectrum Health in Grand Rapids, MI, still hears people calling HITECH an unfunded mandate.

"There is still that concern out there that some health systems cannot afford and are not prepared to embrace meaningful use," he says.

One sign that smaller healthcare organizations will soon adopt EMRs? The vendors are starting to target smaller and smaller organizations, he says.

"HITECH is providing the incentive for participation. Funding is still an issue, but now under HITECH you have five years of a carrot and then that carrot becomes a stick," Jack Kowitt, chief information officer for Parkland Health and Hospital System in Dallas, TX, said in the 2010 CIO survey report.

Despite all of the "buyers beware" concerns, the pressure to purchase a system remains immense, agrees Harrison. "The government threatens future punitive fee schedule payment cuts and tells us the 'clock is already ticking.'"

The future impact
In the survey, most CEOs said the HITECH Act would have either a very positive (13%) or slightly positive effect on future business. But only 17% rate their organization's information technology as "very strong," up slightly from last year's 13%.

Among CIOs, nearly 47% said HITECH will have a slightly positive impact on business. Another 24% said the impact would be very positive.

Most healthcare technology leaders (64%) say the HITECH act will have "some modest success." About 10% said it will have the intended effect to improve quality and reduce costs; 21% said it will not improve quality or cost, and about 4% went so far as to say it will be counterproductive.

"Things have kind of come along," Spencer says. "Overall it feels like there's a lot more momentum now as far as the user interface and the sense of what is important information and how information is dealt with."

There also seems to be more agreement about what information clinicians need to take care of the patient. "That's encouraging," he says. But again, it's not perfect—and it's not where reluctant adopters want it to be, for sure. "Those people are going to hold on for . . . " he says, trailing off before finishing his thought: "I don't know how long."

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