CEO Survival Guide - AHRQ National Resource Center; Health ...

CEO Survival Guide to Electronic Health Record SystemsHIT adoption in ambulatoryphysician practice is positivelycorrelated with:• Larger size• Multispecialty practice• Ownership by an integrated healthcaredelivery system• Increased managed care revenue(Fonkych and Taylor, 2005)The sizable difference in EHR systemadoption rates between large and smallpractice settings raises serious concerns andpolicy issues since the majority of physicianspractice in settings of fewer than 5 physicians(Kane, 2001). About 75 percent of Medicareoutpatient visits are to physicians in practiceswith fewer than 50 physicians, indicatingthat the majority of Medicare outpatientvisits (2001 data) were to practice settingswith limited or no EHR system capacity(Grossman and Reed, 2005).Hospital SettingsIn larger, more complex settings, such as hospitals,EHR systems are often built over manyyears, often in stages, as outlined by HIMSSAnalytics (see Exhibit 5). Only one in fiveEXHIBIT 5 Hospital Stages of Adoption of EHR System ApplicationsStage 7Hospital has paperless EMR environment;Capable of sharing data with a regional network0%Stage 6 Full physician documentation and charting; full clinical decision support; full PACS