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


Certified EHR Systems in Physician Offices Increase

January 27, 2016

The Health Information Technology for Economic and Clinical Health Act of 2009 provides incentive payments to eligible hospitals and providers that demonstrate the meaningful use of a certified electronic health record (EHR) system.

In 2010, the Office of the National Coordinator for Health Information Technology began certifying EHR systems as having the capabilities that could enable meeting meaningful use criteria.

A new NCHS report uses the National Electronic Health Records Survey to describe physician adoption of certified EHR systems from 2013 to 2014 across the United States and the extent to which physicians with certified EHR systems share patient health information.

Findings:

  • In 2014, 74.1% of office-based physicians had a certified EHR system, up from 67.5% in 2013.
  • The percentage of physicians who had a certified EHR system ranged from 58.8% in Alaska to 88.6% in Minnesota.
  • In 2014, 32.5% of office-based physicians with a certified EHR system were electronically sharing patient health information with external providers.
  • The percentage of physicians with a certified EHR system electronically sharing patient health information with external providers ranged from 17.7% in New Jersey to 58.8% in North Dakota.

 


Progress With Electronic Health Record Adoption

February 19, 2015

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides incentive payments to eligible hospitals and providers that demonstrate the meaningful use of a certified electronic health record (EHR) system.

A new report describes the adoption of EHRs in hospital emergency departments (EDs) and outpatient departments (OPDs) from 2006 through 2011 using the National Hospital Ambulatory Medical Care Survey.

Key Findings from the Report:

  • In 2011, 84% of hospital emergency departments used an electronic health record system.
  • Adoption of a basic EHR system with a specific set of functionalities by EDs increased from 19% in 2007 to 54% in 2011.
  • In 2011, 73% of hospital outpatient departments used an EHR system, up from 29% in 2006.
  • Adoption of a basic EHR system with a specific set of functionalities by OPDs increased from 9% in 2007 to 57% in 2011.
  • From 2007 through 2011, adoption of Stage 1 Meaningful Use objectives by EDs and OPDs increased.
  • In 2011, 14% of EDs and 16% of OPDs had EHR technology able to support nine Stage 1 Meaningful Use objectives.

Electronic Health Record Adoption Continues to Climb

March 26, 2014

While adoption of electronic health record (EHR) systems has grown rapidly, little is known about physicians’ perspectives on its adoption and use. Nationally representative survey data from 2011 are used to compare the perspectives of physicians who have adopted EHRs with those that have yet to do so across three key areas: the impact of EHRs on clinical care, practice efficiency and operations; barriers to EHR adoption; and factors that influence physicians to adopt EHRs.

A group of researchers – Eric W. Jamoom, Vaishali Patelb, Michael F. Furukawab, and Jennifer King – concluded that purchase cost and productivity loss are the greatest barriers to EHR adoption among both adopters and non-adopters; although non-adopters have significantly higher rates of reporting these as barriers. Financial incentives and penalties, technical assistance, and the capability for electronic health information exchange are factors with the greatest influence on EHR adoption among all physicians.

The article, “EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption,” was posted online in the March 2014 edition of the Science Direct.

LINK:

http://www.sciencedirect.com/science/article/pii/S2213076413000845