Physicians report EHR vendor selection top barrier to achieving meaningful use

Physicians have reported to regional health IT extension centers (RECs) that waiting for vendor technology upgrades and subsequent certification are among their biggest barriers for making meaningful use of EHR systems.

The Office of the National Coordinator for Health IT (ONC) has analyzed early information from the RECs about the reported obstacles that their enrolled physicians face in transforming their practices.

As of January, ONC had received 4,100 reports of barriers from the RECs. Some physicians reported more than one, said ONC staffer Dawn Heisey-Grove.

The RECs found that vendor selection accounted for the largest portion, or 34 percent, of all reported barriers. But the problems related to vendors are not for a lack of them.

“My general sense is I think it may be an overabundance of choices. Hundreds are certified. And a large portion of providers were doing rip-and-replace,” Heisey-Grove told a Feb. 7 meeting of the meaningful use panel of the advisory Health IT Policy Committee.

The data from the RECs about how physicians are handling the measures for stage 1 of meaningful use is trickling in just as the Centers for Medicare & Medicaid Services is preparing to release later this month its proposed rule for stage 2.

Despite reporting practice-level obstacles, 26 percent of the physicians said they were still on track to achieve meaningful use, according to the ONC analysis.

The idea was to collect empirical evidence to support testimony from providers in public hearings, said Josh Seidman, director of ONC’s meaningful use division. ”One of the important things for meaningful use is understanding real-world experiences, and this is some of the first real-world data we’ve gotten and provided in a quantitative way,” he said.

ONC created the 62 RECs around the country to offer hands-on assistance to providers in getting over the hurdles of deploying EHRs and demonstrating meaningful use. The RECs supply certain data to a customer relationship management system and to ONC, which has also asked for feedback on the barriers.

About half of the RECs have contributed information about hurdles, Heisey-Grove said, and she anticipates more will do so.

Also causing stress among physicians were certain meaningful use measures, specifically making clinical summaries available to patients after a visit -- either printing them out or making them accessible through a patient portal, she explained. Security review was another troublesome core measure. But about one-third said that they were just waiting to do the security assessment.

Adoption of changes to practice workflow to incorporate EHRs and meaningful use processes were also problematic for many physicians and their staff, Heisey-Grove noted.