A December 2014 Data Brief released by The Office of the National Coordinator for Health Information Technology (ONC) analyzed motivating factors of electronic health record adoption, as well as reasons for not adopting. Most physicians (8 out of 10) have already implemented a system or are planning to do so. 1 out of 10 don’t plan on adopting EHR software; however, 41% of those list retirement as the main reason for this decision.

Several physicians are still hesitant to accept the technology. Those in solo practices had higher percentages of physicians hesitant to adopt or not willing to adopt EHRs. Larger practices have better support systems and greater access to resources, making it easier for them to implement new systems. Only 5% of those in practices with 4-10 physicians and only 3% of those in practices of 11+ physicians were uncertain about EHR adoption. Of the physicians not open to EHR adoption, most were surgical specialists. Family practice EHRs and internal medicine EHRs are more common than specialty specific systems, which may be the reason for this. The brief also analyzed urban vs. rural location, but this doesn’t seem to be a factor in the decision to adopt EHR software as the numbers were quite similar.

Those who adopted an EHR system before 2010 cited electronic exchange capabilities as their leading reason (27%), with financial incentives as a close second (23%). Meanwhile, 62% of physicians who adopted an EHR system between 2010 and 2013, after the HITECH Act was passed, cited incentive payments as an important factor in their decision. Other major influences include board certification requirements (39%), trusted colleagues using EHRs (37%), electronic exchange capabilities (36%), and technical assistance with system implementation (35%).

Of the physicians who are still considering EHR adoption, 51% would be most influenced by financial incentives, followed by 46% for technical assistance with implementation, and 44% for board certification requirements. 34% of those who haven’t yet adopted a system have already applied or plan to apply for incentive programs, which require meaningful use software. 67% of those who don’t plan to adopt an EHR cite a lack of resources as their reason; 57% specifically cite lack of financial resources as their reason.

The results of the ONC brief all point to practice finances as the largest factor in electronic health record adoption. Financial incentives are clearly a driving factor in adoption, as can be seen with the reasoning of those who adopted an EHR before the HITECH Act and those who adopted an EHR after it. Moving forward, EHR and practice management software with integrated medical billing services and revenue cycle management should be emphasized as these systems offer assistance and support beyond the implementation stage and can best help practices achieve meaningful use.

Author: Apoorva Anupindi

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