Predictions on EHR adoption in 2012

I mentioned that I’d be doing some predictions on EHR adoption in 2012. Well, it turns out that I did a large part of my EHR adoption predictions in my Meaningful Use 2012 Predictions post. Here’s the section on EHR adoption prediction in case you missed it:

Hospitals Capitalize – My best prediction is that hospitals will see the money flowing and be unable to resist following the money line. We’ve already largely seen this shift in hospitals IT projects. I know a number of healthcare entrepreneurs who have said that hospitals aren’t really doing any major IT projects outside of meaningful use. Hospitals will continue this trend and will likely end up taking the majority of the EHR stimulus money that’s being paid out.

Small Doctors Offices Stay Away – As I wrote about previously, most EHR incentive money is being paid to existing EHR users. In 2012 we’ll be moving past those existing EHR users and I predict that most small doctors offices will continue to sit on the sideline of EHR. The money isn’t large enough for small doctors to overcome all the work required for them to implement an EHR and the EHR penalties are a drop in the bucket for most of these doctors.

I imagine that many will be thinking, “What about the other EHR benefits beyond EHR stimulus money?” To that I’d say, you’re absolutely right. There are plenty of other benefits to having an EHR that don’t include government money for EHR. Unfortunately, the free government money has created this myopic view of the world where those other benefits have lost all their appeal.

With that as background, I personally still say that we’re probably somewhere around 25% EHR adoption. I’m talking about doctors who chart in their EHR all day every day. Certainly the number is much higher if you expand it to anyone who is charting something electronically.

My ambitious guess is that we may even reach 50% EHR adoption by the end of 2012. To me this would be a huge jump, but it seems that the momentum might just be there to make that big jump. I didn’t think this previously, but an experience yesterday at my wife’s OB/GYN has me thinking that EHR adoption may come quicker than I think. Although, it also firmed up my idea that after this wave of EHR adoption we’re going to hit a nasty wall.

A Little History
First let me tell you that my wife and I have been going to this OB/GYN for about 6 years. She’s an older physician who we love. I think that love happens after a miscarriage and two healthy babies. Being that I was working in the EMR field, every time my wife’s gone for an appointment I’ve asked this doctor what she thought of EMR. I believe in our first encounter about 5 years ago her response was something like, “I’ll never do an EMR. I’m good with my paper charts.”

With our last child (he is now 2.5 years old), I mentioned that there was some free government money for EHR. Her response stuck with my wife and I. She literally laughed one of those spontaneous can’t stop laughs and then almost to herself said, “Free money for EHR…*more laughing.”

Needless to say she wasn’t that interested in EHR or any free government money.

Yesterday’s Visit
My wife had another appointment with the OB/GYN yesterday and I decided to tag along. Yes, I mostly just wanted to poke her about EHR use again to see where she was when it comes to EHR and hear her perspectives. She came into the room and said something about not having my wife’s full chart and needing to get it out of storage. I saw the perfect opportunity and so I asked her where her EHR was. She responded, “We have an EHR.”

I was a little taken back by her response. First, because she was so anti-EHR before. Second, because she what seemed like a relatively full paper chart in her hand and was asking for the old paper chart to be pulled from storage. I then prodded some more and said, then where is your EHR? She said it was in the hall. She saw 7 patients an hour (did I hear that right?) and there’s no way she could do the EHR and keep that productivity. I then asked her when she did her charting in the EHR, after hours? She kind of nodded with those stares that mostly says, “I still haven’t figured out how I’m going to get my charting done in the EHR.”

When my wife and I were heading to leave, my wife’s doctor asked what I believe was a nurse in the office which EHR software they were using. Yes, she knew the name of the company, but this EHR company has 6-8 EHR software (I bet you can guess which one) and she didn’t know which one they had. The other lady was going to pull up the EHR so I could see, but the EHR was down. Needless to say, I knew the company and the product quite well. In fact, I have an an entire thread on EMR and EHR about this EHR company with people complaining about it.

As we were leaving, my wife’s doctor said, “I hate EHR. It makes me feel like I’m crazy.” (as she held her hands up next to her head in the universal sign for getting driven crazy) Then she pulled out the “Sucks” word as she referenced her EHR vendor.

As I say above. This story just reinforced my view that many like this anti-EHR doctor will adopt EHR in 2012, but if others experiences are anything like her experience then we’re going to hit a massive wall.

For those wondering, my wife’s appointment went well. At her next appointment I’ll have her leave my business card and see if I can do lunch with her doctor some time to get the rest of the story. I want to ask her what she thinks of Meaningful use! lol

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

9 Comments

  • I would like to read the thread on this paticular EHR and the complaints previously posted, where can I find it?

  • I can imagine that this doctor is not very invested in the EHR concept and that this is partly because someone else has made the decision for her. In larger groups and hospitals, this lack of choice is unfortunately inevitable.

  • I’m sure the group made the decision in this case. The hard thing is that she was likely uninterested in EHR and so she probably didn’t take part in the EHR selection process and now she’s paying the price for it.

  • Actually, it’s more likely that she was not allowed to participated in the selection process, which is usually not allowed to the mere minions hired as employee staff docs. It’s a shame, but usually how big organization works.

  • Possible, but this group is small enough I’m sure she was some part of the decision and could have likely been a bigger part if she’d wanted to be.

  • One of the reasons why physicians are not fully implementing their new EMR is because they have not converted both their active and backfile of paper charts into a digital medium. Most EMR salespeople never address this issue fully and usually recommend only scanning either a few pages of the paper chart or completely skirt the issue all together. By a practice not scanning their paper charts the practice is now operating in a hybrid environment of both paper and electronic charts. A physician who operates in this environment will naturally gravitate towards the paper chart. Until healthcare providers address the fundamental foundation of EMR by scanning their active and backfile of paper charts the headaches will continue.

  • Todd,
    Said by someone who does scanning for clinics. I think you’re describing something that could be an issue, but if people are careful to use the new EHR and only use the paper charts as reference then it’s not as big of a deal as you suggest.

    Of course, I definitely think you have to have a plan for how to deal with the old paper charts. One great option is outsourcing the scanning of the old paper charts. Combine that with clinical data extraction and it’s very nice. A little expensive for some, but very nice when completed.

  • John,
    I will politely disagree with you. We are seeing this issue on an almost daily basis especially with older physicians and rural healthcare providers. As far as the “high” cost of third party scanning of the practice’s back file is simply not true when you compare the cost of maintaining, labor and retrieving those charts for a minimum of 7 years. I just prepared a ROI for a solo doctor who is maintaining 1,000 boxes offsite. His annual expense is $70K per year. Multiply that times 7 years and you are looking at approximately $490,000. Our bid to scan his last six years plus his active charts and purge the seventh year amounted to $149,000. All of these paper charts will now be OCR’d (Optical Character Recognition) which allows the practice to key word search the entire data base which in turn increases efficiencies within the practice saving additional labor costs.

  • Of course, the number that changes is the annual expense for a clinic to store and access past charts. That number can vary widely depending on the cost of the space and new revenue you could gain if you free up that space.

    Don’t get me wrong, I’m a fan of back scanning. None of the offices that I’ve worked for have any paper charts left. However, there are a number of ways to reach that goal and a number of approaches that can make sense depending on the situation.

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