Survey: EMR adoption up, but key barriers remain

Source: Great Plains Regional Medical Center

EMR adoption is up from 2011 at U.S. hospitals but six key barriers remain, according to a survey commissioned by the Optum Institute for Sustainable Health published Feb.15.

The Optum Institute commissioned Harris Interactive to conduct a survey of 301 U.S. hospital CIOs to explore overall progress in digitizing medical care, current health IT capabilities, plans for health IT expansion, stage of meaningful use progress, value of interoperability and benefits and challenges associated with technology use. The survey was conducted online by Harris Interactive between December 2011 and January 2012.

Nearly nine out of 10 hospitals surveyed (87 percent) now have EMR systems in place–up significantly since 2011, when the Healthcare Information and Management Systems Society (HIMSS) reported that only slightly more than half of CIOs had a fully operational EMR in at least one facility in their organization. Seventy percent of CIOs reported their systems have attested to meaningful use stage 1 criteria and 75 percent anticipated being able to meet expected meaningful use stage 2 criteria by 2014.

“Hospitals are making substantial gains in adopting EMRs, participating in health information exchanges, and achieving ‘meaningful use,’” said Simon Stevens, chairman of the Optum Institute. “But hospital CIOs are clearly signaling that technology gaps remain, genuine interoperability remains elusive, and–as a result–most U.S. hospitals are still some way off from being fully ready to play their part in managing population health and its related financial risk.”

The survey identified six main technology concerns facing hospital CIOs:

• Technology-related spending continues to rise: Nearly 80 percent of respondents said they had to modify their system significantly in some way or purchase another system entirely. For those that have implemented EMR and health information exchange (HIE) systems, hospital CIOs reported that new capabilities have so far raised hospital costs, not reduced them.
• Gaps in key care information: Almost two-thirds of hospitals said they own their own HIE, but key care information, including hospital discharge information, computerized prescriptions, physician clinical notes and lists of patient allergies and medications, is available only about half the time.
• Interoperability is a major concern: Among those participating in an HIE, data are on average accessible for only 60 percent of patients through the HIE. Two-thirds of respondents found data accuracy/completeness to represent the biggest business and technical issue they faced in using HIE capabilities, followed by inaccessible proprietary systems and high costs of interoperability.
• Compliance barriers: For those that have an EMR system, the largest barriers to complying with meaningful use requirements include cost (57 percent), sufficient time (55 percent) and legacy system incompatibility (34 percent).
• Extending systems to the cloud: Recognizing the benefits of cloud computing, 59 percent of those who have an HIE/EMR system plan to invest in cloud-based open systems.
• Reform readiness: Hospital CIOs reported being more prepared to assume broader responsibility in managing patient care than financial risk. Still, only one in four CIOs reported that hospitals in their community are extremely/very prepared for increased responsibilities from managing patient care, and only 15 percent said they are extremely/very prepared for managing the associated financial risks.