EHR

The Agency for Healthcare Research and Quality has released a white paper highlighting best practices for leveraging health IT in an effort to improve primary care quality, EHR Intelligence reports.

White Paper Details

The white paper highlights several tools that can improve care quality and facilitate further adoption of health IT among primary care physicians. For the paper, AHRQ gained insights from:

• A large academic primary care facility;
• A primary care-supporting health information exchange organization;
• Clinicians from an independent primary care practice; and
• Health IT experts.

Findings

In the white paper, AHRQ noted that key health IT tools for primary care providers include:

• Electronic health record systems;
• Clinical decision support systems;
• HIE capabilities; and
• Registries.

In addition, AHRQ identified four factors that contribute to effective use of health IT, including:

• A practice culture committed to health IT;
• High-functioning health IT tools capable of tracking;
• A knowledgeable staff with health IT and quality improvement experience; and
• Workflows and processes that incorporate health IT.

The white paper also included case studies to demonstrate ways providers can incorporate health IT tools into their practices (Gruessner, EHR Intelligence, 3/31).

Epic Systems controls the largest share of the physician electronic health record adoption market, according to a new survey from SK&A, EHR Intelligence reports (Bresnick, EHR Intelligence, 2/17).

Survey Details

The survey assessed EHR adoption rates of more than 500 vendors. Adoption rates among physicians were divided into several subcategories, including:

• The number of physicians and exam rooms onsite;
• Practice specialty;
• Site ownership; and
• State (SK&A survey, February 2015).

Findings on EHR Vendor Market Share

The survey found that Epic holds 11.6% of the outpatient EHR market, up by more than 1% from last year (EHR Intelligence, 2/17).

Vendors with the next largest EHR market shares include:

• eClinicalWorks, with 10.2%;
• Allscripts, with 8.7%;
• Practice Fusion, with 6.7%; and
• NextGen Healthcare, with 5.5% (SK&A survey, February 2015).

The survey found that eight vendors control 53% of the physician EHR market, compared with last year when 10 vendors shared the same percentage of the market. Meanwhile, the top 20 vendors made up slightly less than 75% of the EHR adoption market.

According to the survey, 27% of providers are using nearly 500 different EHR products. Further, it found that small practices were much more likely than large groups to use a less-known EHR vendor, with nearly 30% of practices with one to three physicians selecting such a vendor (EHR Intelligence, 2/17).

Findings on Physician EHR Adoption

The study also showed that EHR adoption rates were highest among physician groups:

• With 11 to 25 doctors on site, at 79.5%;
• With 11 or more exam rooms, at 78.8%;
• Specializing in internal medicine/pediatrics, at 76.3%; and
• That were hospital owned, at 70.9%.

In addition, the survey found that the top five states for physician office EHR use are:

• Wyoming, at 74%;
• South Dakota, at 72%;
• Utah, at 71%;
• Iowa, at 70%; and
• Arkansas, at 69%.

Meanwhile, the states with the lowest physician office EHR adoption rates are:

• New York, at 57%;
• New Jersey, at 57%;
• Louisiana, at 56%;
• District of Columbia, at 55%; and
• Rhode Island, at 54% (SK&A survey, February 2015).

The Office of the National Coordinator for Health IT has released a guide designed to assist providers with electronic prescribing, Becker's Health IT & CIO Review reports (Jayanthi, Becker's Health IT & CIO Review, 2/19). 

Background

About 70% of physicians e-prescribe, and about 90% of pharmacies are able to accept e-prescriptions, according to ONC.

Studies have shown e-prescribing can reduce drug costs and assist with medication management (Durben Hirsch, FierceEMR, 2/17).

Meanwhile, e-prescribing of controlled substances is legal in just 48 states and Washington, D.C. Legislation to allow e-prescribing of such medications by mid-2015 is pending in Missouri and Montana (Surescripts release, 2/19).

Guide Details

According to FierceEMR, the guide, called "A Prescription for e-Prescribers: Getting the Most Out of Electronic Prescribing," aims to help prescribers learn about e-prescribing. In addition, the guide shows prescribers ways to improve their use of e-prescribing and outlines the eight stages of the process. Those stages are:

• Identify the patient;
• Review existing patient data;
• Select a drug from a menu in the electronic health record;
• Enter information for the pharmacy;
• Review advisories and alerts;
• Choose a pharmacy;
• Authorize and sign prescription; and
• Review expectations with patients, monitor e-prescribing logs and manage electronic renewal requests.

The guide also poses some questions for e-prescribers to consider, such as whether the EHR lets a prescriber store a patient's preferred pharmacy (FierceEMR, 2/17).

"Some of these changes can result in decreased pharmacy call backs to the practice, increased patient satisfaction and improved e-prescribing productivity," according to the guide. It added, "Recommendations to create unambiguous prescriptions with standardized information enable effective clinical decision support and enhanced patient safety" (Walsh, Clinical Innovation & Technology, 2/19).

ONC has said the guide is best-suited to prescribers who use EHRs to send e-prescriptions, rather than a standalone system (FierceEMR, 2/17).