On the Road to Meaningful Use of EHRs: A Survey of California Physicians

University of California, San Francisco

Electronic health records save physicians time and money, yet many don't use them. This survey reviews eligibility for federal funds to encourage use of this technology.

June 2012

Although use of electronic health records (EHRs) can improve care coordination and quality, patient safety, outcomes reporting, and provider efficiency, some physicians have been slow to adopt the technology. To encourage the "meaningful use" of EHRs, the federal government created an incentive program for health providers, administered through Medicaid. The Health Information Technology for Economic and Clinical Health (HITECH) Act authorized the federal funding of this program.

This report summarizes a survey of California physicians about their current use of EHRs and their eligibility for the Medi-Cal EHR incentive program.

Some key findings:

  • Although 71% of physicians surveyed have an EHR system, only 30% have EHRs configured to meet all 12 of the meaningful use objectives measured in the study.
  • Rates of EHR availability are lowest among physician solo practitioners, small partnerships, and community/public clinics. Office-based physicians are less likely to have EHRs than those in hospitals, and rural physicians are less likely to have them than urban physicians.
  • Most physicians who, based on their survey responses, are eligible for incentive payments (70%) do not currently have EHRs that can meet all 12 of the meaningful use objectives measured.
  • Many physicians are not familiar with the eligibility rules for the Medi-Cal EHR incentive payment program. A substantial percentage of survey respondents who are eligible for the payment program believe that they are not eligible, do not plan to apply, or need further information before deciding to apply. At the same time, a number of respondents who plan to apply do not appear to be eligible.

An estimated 21,598 physicians will be eligible for the Medi-Cal EHR incentive payment program based on their payer mix, practice setting, and practice type. This number will grow with the increase in Medi-Cal enrollment in 2014 under the Patient Protection and Affordable Care Act (ACA).

The full report is available as a Document Download.

Related Reports (February 2013)

CHCF commissioned two additional reports to assess hospitals', nurse practitioners', and nurse midwives' meaningful adoption and use of EHRs and related qualification for Medicaid incentives. Findings from an analysis of California hospitals are reported in California Hospitals 2010: Electronic Health Record Adoption, Meaningful Use, and Health Information Exchange. Findings from an analysis of California nurse practitioners and nurse midwives are reported in Use of Electronic Health Records by Nurse Practitioners and Nurse Midwives. Both are available on the California Medicaid Research Institute website.

Reader Comments

Great report with useful data on the current state of EHR adoption in California. Not surprisingly, safety-net providers: small, independent physician practices, rural providers and those working in community clinics, are behind the adooption curve. The report fails to mention that California's four federally-funded Regional Extension Centers have been very successfull in working with this target group of providers-in fact, the majority of the providers currently getting paid by Medi-Cal are members of the REC program. Stronger partnerhips between Medi-Cal and the REC programs could help address some of the challenges outlined in the report.

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