The trend towards adoption has been building over the past several years, matching the development of more mature EHRs in the marketplace. The efforts of the Office of the National Coordinator (ONC) for Health IT, as it has defined “meaningful use of certified EHR technology,” has been a major factor in encouraging both (1) adoption of EHRs by physicians, aided by stimulus funds earmarked in the 2009 ARRA legislation, and (2) the emergence of new EHR technology to deliver a set of features felt to be significant and supportive of national health IT policy.
According to the criteria for “basic” and “fully functional” electronic medical record systems used in the CDC survey, which represent a feature-set first defined in a 2008 sentinel report by the Robert Woods Johnson Foundation, the features needed for ONC-ACTB Certified EHR technology (what is needed in order to access Meaningful Use bonus funding starting in 2011) are consistent with the “fully functional” definition – plus extra features not available when the report was originally undertaken (such as patient access to customized health education, or reporting of immunizations to local and state registries, or public health reporting of syndromic data).
This growing tide of EHR adoption matches the experience we have had at Practice Fusion. Being a relatively new EHR in the market, Practice Fusion has pioneered use of the web as a deployment platform for EHRs (rather than the locally-installed legacy that had created big obstacles, especially for smaller practices). And with a business model that allows the product to be offered as a free service to physician end-users, as well as a rapid self-service set-up that allows practices to simply go to a web site and sign up themselves in order to get started that same day (“Live in Five”), the growth in 2010 has been phenomenal.
In 2010, Practice Fusion went from 15,000 users to 60,000 – a 450% growth. Those who are active, meaningful users of the system also grew 700% (a statistic that can be realistically measured in a hosted, web environment, and very difficult to measure in a sales-oriented locally-deployed setting – such EHR vendors can only measure sales, but don’t know if their EHR is sitting on a computer in a corner gathering dust). Patient records uploaded into the system grew from 1,000,000 at the beginning of the year to over 6,000,000 by the end of the year, making it one of the largest patient-record repositories in the country.
The growth curves of EHR adoption reported by the CDC should shift dramatically in 2011. ONC-ACTB Certification incentivizes physicians to adopt “fully functional” systems, and the availability of such systems in new and innovative deployments (free, web-based, self-service) will help move this curve significantly. It has already done so.
2010 has been an exhilarating year for those of us in the EHR development field. 2011 and beyond will move us all into a level never before seen. The days of visiting your physician in her office, and finding it to be a swamp of paper, are waning. The future of healthcare will be one where high-usability (allowing physicians to work quickly, without the technology getting in the way), high-mobility (wireless, web-based systems), data-driven (all the patient info is at-hand at the moment of care, including all the appropriate disease-management clinical-decision-support prompts) technology is available to everyone. It will be the new “standard of care.”
Robert Rowley, MD
Chief Medical Officer
Practice Fusion
