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Assessing the Economics of EMR Adoption and Successful Implementation in Physician Small Practice Settings
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Author(s): Moshman Associates; Booz, Allen, Hamilton |
Organization(s): Moshman Associates; Booz, Allen, Hamilton |
Electronic Medical Records (EMRs) are viewed as a means to achieve improved health care quality and reduced costs. In 2004, President Bush announced a lO-year goal of making EMRs available to most Americans. A number of public and private sector initiatives focus on promoting the adoption of HIT such as community-focused initiatives funded by the Agency for Healthcare Research and Quality (AHRQ) and physician-focused initiatives like the Doctor's Office Quality-Information Technology (DOQ-IT) program. Despite these and other initiatives, the adoption ofEMRs has been limited with adoption rates varying widely across care settings (rates in ambulatory settings range between 15 and 18 percent). With approximately 75 percent of physician practices employing fewer than nine physicians, such low adoption rates among small practices does not bode well for the national goal of achieving broad EMR diffusion in 10 years. Low rates of EMR adoption have been attributed to a variety of forces including misaligned financial incentives, lack of standardization among EMR applications, and the high turnover of HIT vendors. However, there are few studies that have examined, at a microeconomic level, the various economic and non-economic factors that promote or deter EMR adoption in small practice settings. To provide a deeper understanding of the factors that impede or impel EMR adoption in physicians' small practices, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the Department of Health and Human Services (HHS) engaged Moshman Associates and Booz, Allen, Hamilton to assess the economics ofEMR adoption and implementation in physician small practice settings. This comprehensive report details the findings of the first phase of a two phase study. |
Published: September, 2006 |
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Health Information Exchange in Post-Acute and Long-Term Care Case Study Findings: Final Report
(Report)
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Author(s): Rachael E. Bennett, Mark Tuttle, Karis May, Jennie Harvell and Eric A. Coleman |
Organization(s): University of Colorado |
The purpose of the study was to:: (1) describe the current status of the use of health information technology (HIT) in existing state-of-the-art health delivery systems and how health information is or is not exchanged with "unaffiliated" post-acute and long-term care (PAC/LTC) providers and other components of the health care delivery continuum (e.g., physician offices, laboratories, pharmacies, and hospitals) that use health information technology; (2) identify the factors that support or deter the timely exchange of health information to and from unaffiliated PAC/LTC providers and other components of the health care delivery continuum that use HIT; and (3) identify ways in which policy makers and others can encourage (a) information exchange between health delivery systems that use HIT with unaffiliated PAC/LTC providers and (b) use of HIT in PAC/LTC. [182 PDF pages] |
Published: September, 2007 |
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Taxonomy of Health Information Technology Functions in Nursing Homes -- Report B: Review by Representatives from Nursing Homes and Vendors
(Report)
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Author(s): University of Colorado |
Organization(s): University of Colorado |
This is the second report in a series that is describing the findings from stakeholders. The background on the taxonomy development is described in more detail in Report A and it is the expectation of the authors that these reports would be read as a set. A select group of nursing home providers was invited to provide feedback on the draft taxonomy and information on which applications are currently in use (or planned for future implementation) and the extent to which they are used. This report provides a summary of the findings from this review. [35 PDF pages] |
Published: August, 2007 |
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Taxonomy of Health Information Technology Functions in Home Health Agencies -- Report C: Review by Representatives from Home Health Agencies and Vendors
(Report)
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Author(s): University of Colorado |
Organization(s): University of Colorado |
This is the third report in a series describing the findings from stakeholders. The background on the taxonomy development is described in more detail in Report A and it is the expectation of the authors that these reports would be read as a set. A group of home health agency providers was invited to provide feedback on the draft taxonomy and information on which applications are currently in use (or planned for future implementation) and the extent to which they are used. This report provides a summary of the findings from this review. [34 PDF pages] |
Published: August, 2007 |
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Taxonomy of Health Information Technology Functions in Nursing Homes and Home Health Agencies -- Report A: Review by Representatives from Standards Development Organizations
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Author(s): University of Colorado |
Organization(s): University of Colorado |
This paper reports on findings from a circumscribed literature review and multiple stakeholder discussions pertaining to the use of and need for health information technology applications in nursing homes (NHs) and home health agencies (HHAs). Through these two data collection methods, the authors have attempted to identify and organize the types of electronic point-of-care and information exchange applications and functions currently used in NHs and/or HHAs (beyond federally-mandated OASIS and MDS reporting and claims submission). [40 PDF pages] |
Published: August, 2007 |
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Consumer Control of Electronic Personal Health Information: What Does It Mean? Why Is It Important?
(Report)
A Report on Three Consumer Focus Group Meetings Convened in October, 2005 by the Office of the Assistant Secretary for Planning and Evaluation |
Author(s): Susan Kanaan, Suzie Burke-Bebee, and Helga E. Rippen |
Public and private health care sectors recognize that health information technology (HIT) plays a pivotal role for improving health care quality while reducing health care cost. Many new initiatives have created a momentum greater than in the past for adopting electronic health records (ERRs) and HIT in general. In the current environment, the principle that the patient and consumer control their personal health information (PHI) is frequently invoked and linked to the broader principle of patient-centricity. Surveys by the Markle Foundation and the California Health Care Foundation confirm that most consumers are concerned about the privacy and security of their PHI. While many consumers recognize the benefits of EHRs and other forms of HIT, they want and expect to control access of their PHI-who sees it, what they see and under what conditions. An immediate challenge persists in defining what control means to the consumer and soliciting consumer engagement in workable solutions as the industry plans for HIT implementation. To this end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the Office of the Secretary at the Department of Health and Human Services hosted three consumer focus group meetings in October 2005 for day-long discussions on these topics. This report provides a description of the focus groups' discussions. |
Published: March, 2007 |
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Report on Health Information Exchange in Post-Acute and Long-Term Care
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Author(s): Eric A. Coleman, Karis May, Rachael E. Bennett, David Dorr and Jennie Harvell |
Organization(s): University of Colorado, Oregon Health and Science University, US Department of Health and Human Services |
This report is based on the most recent and current developments related to health information exchange in post-acute care and long-term care. It builds upon the previous literature review conducted in the project that examined the status of electronic health records in post-acute and long-term care and research on clinical information exchange needs at times of transition across the health care settings. Therefore, the literature review for this project was a targeted search and was gathered from multiple and varied sources with the intention of obtaining only the most up-to-date material available. [61 PDF pages] |
Published: February, 2007 |
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Evaluation Design of the Business Case of Health Information Technology in Long-Term Care: Final Report
(Report)
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Author(s): Booz Allen Hamilton |
Organization(s): Booz Allen Hamilton |
The purpose of this project was to help design a study to assess the business case for health information technology in post-acute care (PAC) and long-term care (LTC) settings. This effort is to inform providers, payors, policymakers and others regarding the costs and benefits (financial and non-financial) of health information technology in the PAC/LTC environment. [88 PDF pages] |
Published: July, 2006 |
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Making the "Minimum Data Set" Compliant with Health Information Technology Standards
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Author(s): John Carter, Jonathan Evans, Mark Tuttle, Tony Weida, Thomas White, Jennie Harvell and Sam Shipley |
Organization(s): Apelon, Inc. |
The goals of this study were to make the MDS compliant with CHI-endorsed content and messaging standards, and to produce a policy relevant report that describes the issues with integrating these HIT standards into federally-required patient assessment applications. This report summarizes the complete findings and recommendations of this study. [485 PDF pages] |
Published: May, 2006 |
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Costs and Benefits of Health Information Technology
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Author(s): Paul G. Shekelle, Sally C. Morton and Emmett B. Keeler |
Organization(s): Southern California Evidence-based Practice Center |
This report is a synthesis of studies that have examined the quality impact of health IT as well as the costs and organizational changes needed to implement health IT systems. This report reviews scientific data about the implementation of health IT to date, as documented in studies published through 2003. It does not project future health care benefits or savings, in contrast to other reports. [168 PDF pages] |
Published: April, 2006 |
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