Slide Presentation of the 2007 Annual Meeting of AHRQ

The Big Picture is As Murky As It Ever Was...

• The message on quality and measurement is starting to sink in, but there is no sense of urgency
  • Large groups and hospital-employed moving faster, but small practice penetration is lethargic
  • Small practices don't see this as a "competitive advantage"
• Current reimbursement model doesn't provide enough focused incentives to accelerate adoption, largely because of upfront capital and technical capacity hurdles
  • Supply- and demand-side too fragmented
  • P4P without EHRs too shallow to make a difference
• Even if adoption increased on its own, the market won't implement these systems to deliver value
  • Bad systems and/or bad implementations offer little, if any, value
  • Failure in retail market is on the order of 30%
  • EHRs don't spontaneously generate meaningful clinical data—required behavior and process changes are rarely implemented by practices on their own
  • Physicians don't capture (or understand) the full benefit of connectivity, so they won't invest in it on their own
  • Not clear how to develop interoperable network in laissez-faire model—medical trading areas not formally organized in a way that facilitates definition of local network business