KHI News Service

Use of electronic health records surges in U.S., survey finds

Billions of dollars in stimulus incentives paid out

By Phil Cauthon | November 15, 2012

Commonwealth Fund survey

Primary care doctors use of electronic health records, a comparison of 10 countries in 2009 and 2012.

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More than two-thirds of U.S. primary care physicians were using electronic health records last year, a substantial increase from three years ago, when less than half had adopted the technology, according to a Commonwealth Fund survey published today.

In 2012, 69 percent of primary care physicians reported using an electronic health record (EHR) system, compared to 46 percent in 2009. Among the 10 developed countries surveyed, the U.S. still lags six of them. In those six countries, including the United Kingdom and Australia, EHR use is near universal.

The federal economic stimulus law passed in 2009 provided for incentive payments to doctors and hospitals to implement electronic health record systems that met certain federal standards.

In Kansas, 463 doctors and 31 hospitals have been paid $25.2 million in Medicaid-based incentives since the payments began in late 2011.

Nationwide, more than $3.3 billion in Medicaid incentives has been paid to 55,012 individual providers and to 2,572 hospitals, as of an August report.

Nationwide, Medicare-based incentives so far total nearly $3.5 billion paid to 66,367 doctors and 1,333 hospitals.

Eligible professionals can receive up to $44,000 in Medicare incentives or up to $63,750 in Medicaid incentives over a five-year period. Incentive payments to eligible hospitals are based on a number of factors, but start with a $2 million base payment. Incentives are reduced the longer providers wait to begin implementing an EHR system.

Starting in 2015, hospitals that have not implemented an EHR system will receive reduced Medicare reimbursements.

Other survey findings

• In the U.S. — the only country in the survey without universal health coverage — 59 percent of physicians said their patients often have trouble paying for care. Far fewer physicians in Norway (4 percent), the U.K. (13 percent), Switzerland (16 percent), Germany (21 percent), and Australia (25 percent) reported affordability was a concern for their patients.

• More than half of U.S. doctors (52 percent) said they or their staff spend too much time dealing with insurers’ restrictions on covered treatments or medications — by far the highest rate in the survey.

• In each country, only a minority of primary care doctors reported always receiving timely information from specialists to whom they have referred patients, while less than half said they always know about changes to their patients’ medications or care plans.

• U.S. physicians were the most negative about their country’s health system, with only 15 percent saying the system just needs minor change.

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