Patient Health Information Shared Electronically by Office-based Physicians: United States, 2015

August 15, 2018

Questions for Brian Ward, Health Statistician and Lead Author of “Patient Health Information Shared Electronically by Office-based Physicians: United States, 2015

Q: Why did you decide to focus on office-based physicians who electronically share patient health information (PHI) in the United States?

BW: While previous research has looked at the extent to which office-based physicians electronically shared PHI, it has not provided details as to the types of PHI that are electronically sent, received, integrated, and searched for. Therefore, we decided to expand upon this previous research by describing the types of PHI that are shared electronically.


Q: How did you collect data for this report?

BW: Data from this report were from the 2015 National Electronic Health Records Survey (NEHRS). NEHRS is a nationally representative mixed-mode survey of office-based physicians, and asks about their adoption and use of electronic health records (EHRs). The different modes (or manners) NEHRS uses to collect data are via web, mail, and telephone.


Q: What were some of the most observed types of PHI electronically shared in physician offices?

BW: Among office-based physicians who sent PHI electronically, the most commonly observed types of PHI sent were referrals (67.9%), laboratory results (67.2%), and medication lists (65.1%). Among physicians who received PHI electronically, the most commonly observed types of PHI received were laboratory results (78.8%), imaging reports (60.8%), and medication lists (54.4%).

For physicians who integrated PHI electronically, the most commonly observed types of PHI integrated were laboratory results (73.2%), imaging reports (49.8%), and hospital discharge summaries (48.7%).

Finally, a large majority of physicians who searched for PHI electronically did so for medication lists (90.2%), medication allergy lists (88.2%), and hospital discharge summaries (80.4%).


Q: Do you have trend data that is older than 2015 or is this the first this data has been published?

BW: Older NEHRS data are available, dating back to 2008 (when it was a supplement to the National Ambulatory Medical Care Survey); however, these older data are not compatible with the measures examined in this report.


Q: What is the take home message in this report?

BW: These are the first national estimates of PHI type according to the aspects of interoperability among physicians with EHR systems, and these estimates can be used as a benchmark for future studies. Combined with measures of electronic sharing of PHI by physicians, information on the specific type of PHI shared electronically among office-based physicians will assist in tracking progress outlined in the federal plan for achieving interoperability.

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QuickStats: Percentage of Residential Care Communities That Use Electronic Health Records by Census Region — United States, 2016

July 2, 2018

In 2016, 26% of residential care communities used electronic health records (EHRs).

The percentage that used EHRs was 36% of communities in the Northeast, 41% of communities in the Midwest, 24% of communities in the South, and 17% of communities in the West.

Source: National Study of Long-Term Care Providers, 2016 data. https://www.cdc.gov/nchs/nsltcp/index.htm.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6725a8.htm


QuickStats: Percentage of Residential Care Communities That Use Electronic Health Records, by Community Bed Size — United States, 2016

February 6, 2018

In 2016, one fourth (26%) of residential care communities used electronic health records (EHRs).

The percentage of communities that used EHRs increased with community bed size.

The percentage was 12% in communities with 4–10 beds, 28% with 11–25 beds, 35% with 26–50 beds, 43% with 51–100 beds, and 50% with more than 100 beds using EHRs.

Source: National Study of Long-Term Care Providers, 2016

https://www.cdc.gov/mmwr/volumes/67/wr/mm6704a8.htm


Characteristics of Primary Care Physicians in Patient-centered Medical Home Practices: United States, 2013

February 17, 2017

Questions for Esther Hing, Survey Statistician and Lead Author on “Characteristics of Primary Care Physicians in Patient-Centered Medical Home Practices: United States, 2013

Q: Can you define what a patient-centered medical home (PCMH) practice is?

EH: One of several PCMH definitions is that PCMHs provide care that is: comprehensive care provided by a team of providers, patient-centered care, coordinated care, has accessible services, and care focused on quality and safety.


Q: Why did you decide to do a report on PCMH practices?

EH: Although the PCMH has been advocated by the “primary care community” for more than a decade, there are no national estimates that describe characteristics of this model of care delivery. “Primary care community” includes primary care physicians as well as other primary care providers and associated professional societies. The report, based on questions funded by the Assistant Secretary for Planning and Evaluation (ASPE), will inform policy makers of the prevalence of certified PCMH practices in the United States, as well as care attributes of these practices (compared with non-PCMH practices).

Estimates not only serve as benchmark estimates for this model of primary care, but adds to the knowledge base about this type of practice. Payers and the federal government have increasingly funded PCMH demonstrations, and certain payers and states have also increased funding to practitioners in PCMH practices.


Q: Is the first time NCHS has published a report on this topic?

EH: Yes, this is the first year that the PCMH questions have been reported.


Q: What did your report find on primary care physicians in PCMH practices?

EH: The report found that primary care physicians in PCMH practices tended to be in larger practices, and located in urban areas. These findings may be attributed to infrastructure requirements needed for PCMH care delivery. It may also reflect that in 2013, the Centers for Medicare and Medicaid Service (CMS) demonstrations and payment policy supporting chronic care was not yet implemented or was in early stages of development.


Q: Were there any findings that surprised you?

EH: The finding that a substantial percentage of non-PCMH practices have non- physician clinicians and Electronic Health Records suggests that there is untapped potential for a greater number of primary care practices to become PCMHs.

However, the relatively lower participation by solo and small practices as PCMHs suggests the need for assistance or coaching to make this transformation. The ongoing implementation of payment incentives from CMS and elsewhere has encouraged growth of PCMHs. This is a trend that the National Ambulatory Medical Care Survey (NAMCS) can be used to examine for the next few years and beyond.


Q & A from Lead Author of “State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015”

October 28, 2016
Eric Jamoom, Research Scientist Officer

Eric Jamoom, Research Scientist Officer

Questions for Eric Jamoom, Research Scientist Officer at the Collaborating Center for Questionnaire Design and Evaluation Research and Lead Author on “State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015.”

Q: What findings in the report surprised you and why?

EJ: In this data brief, we are capturing for the first time four elements for measuring the electronic sharing of health information. Specifically, we now have insight into the number of office-based physicians that electronically sent, received, integrated and searched for patient health information from other providers.

Coupled with the recent release of a September 2, 2016 MMWR Quickstat that provided estimates on the number of physicians having electronic access to patient health information at the point of care, information is now available about the state of electronic information sharing by office-based physicians in the United States.


Q: How many office-based physicians electronically sent, received, integrated or searched for patient health information from other providers in 2015?

EJ: In 2015, roughly one-third of physicians indicated they either electronically sent, received, integrated, or searched patient health information in 2015.

Specifically, 38.2% of physicians had electronically sent patient health information to other providers, 38.3% of physicians had electronically received patient health information from other providers, 31.1% of physicians had electronically integrated patient health information from other providers, and 34.0% of physicians had electronically searched for patient health information from other providers.


Q: Which states did you find that electronically sent patient health information to other providers that were higher and lower than the national average?

EJ: In 2015, the percentage of physicians that sent patient health information to other providers ranged from 19.4% in Idaho to 56.3% in Arizona. Arizona was significantly greater than the national percentage, while three states – Idaho, New Jersey, and Connecticut – were significantly less than the national percentage.


Q: Can you explain what you found from state variation among physicians who had electronically searched for information from other providers?

EJ: In 2015, 34% of physicians had electronically searched for patient health information from other providers, ranging from 15.1% in the District of Columbia to 61.2% in Oregon. Five states, which include Texas, Oklahoma, Missouri, Mississippi, and Pennsylvania, as well as the District of Columbia were significantly less than the national percentage. Whereas, 10 states were significantly greater than the national percentage: Alaska, Oregon, Washington, Colorado, Wisconsin, Ohio, North Carolina, Virginia, Maryland, and Delaware.


Q: Do you have trend data that goes further back than 2015 on this topic?

EJ: These data represent new information previously not available before on electronic information sharing of patient health information. Therefore, the information contained in this report represents a baseline for which future data can be used for trend data on these four elements of electronic information sharing among office-based physicians.


Q: Why did you decide to study state variation in electronic sharing of information in physician offices?

EJ: The Health Information Technology for Economic and Clinical Health Act provided financial incentives to eligible providers to demonstrate the meaningful use of a certified electronic health record (EHR) system, which also includes capacity to share patient health information.

In 2015, a federal plan was published to enhance the nation’s health IT infrastructure to support sending, receiving, integrating, and searching for patient health information electronically. The 2015 data from the National Electronic Health Records Survey provides national and state based estimates about physician EHR adoption and use.

 


State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015

October 27, 2016

The Health Information Technology for Economic and Clinical Health Act (HITECH) provides financial incentives to eligible providers using a certified electronic health record (EHR) system.

In 2015, 77.9% of office-based physicians had a certified EHR system, up from 74.1% in 2014. A federal plan to enhance the nation’s health information technology infrastructure was published in 2015 to support information sharing.

A new NCHS report uses the 2015 National Electronic Health Records Survey to describe the extent to which physicians can electronically send, receive, integrate, and search for patient health information.

Findings:

  • In 2015, the percentage of physicians who had electronically sent patient health information ranged from 19.4% in Idaho to 56.3% in Arizona.
  • In 2015, the percentage of physicians who had electronically received patient health information ranged from 23.6% in Louisiana
    and Mississippi to 65.5% in Wisconsin.
  • In 2015, the percentage of physicians who had electronically integrated patient health information from other providers ranged from 18.4% in Alaska to 49.3% in Delaware.
  • In 2015, the percentage of physicians who had electronically searched for patient health information ranged from 15.1% in the
    District of Columbia to 61.2% in Oregon.

QuickStats: Percentage of Physicians Who Have Electronic Access to Patient Health Information from Outside Their Medical Practice by State

September 2, 2016

In 2015, approximately half (50.3%) of the physicians in the United States had information from other providers outside of their practice electronically available at the point of care.

There was wide variation by state, ranging from 34.6% in Idaho to 76.4% in South Dakota.

Sixteen states and the District of Columbia were in the range with the lowest percentage of physicians with electronic access to more comprehensive patient information (34.6%–47.2%).

Another 16 states were in the middle range (47.3%–57%). The 18 states with the highest percentage of physicians having such information electronically available were in the top range (57.1%– 76.4%).

LINK: http://www.cdc.gov/mmwr/volumes/65/wr/mm6534a7.htm?s_cid=mm6534a7_e