When the Center for Medicare & Medicaid
Services (CMS) released data on the number
of Electronic Healh Record (EHR) users with
the nation's healthcare system, the medical
community's response was mixed. Given the Federal government's
emphasis on incentivizing clinicians to make the
digital switch, the reported numbers were considered low
by many. Dermatologists viewed these broader statistics
as useful but sought a portrait of EHR integration within
our own specialty. To that end, the American Academy of
Dermatology (AAD) extracted data on dermatologists who
qualified for Meaningful Use of EHRs, as well as their vendors.
The Numbers
Int total, 518 dermatologists received incentive money for
Meaningful Use in 2011. Of those, 34 percent use Epic systems,
followed by eClinicalWorks (10 percent), NexTech
(nine percent), and Allscripts (eight percent). While Epic
appears to currently have a major advantage over the others,
it's worth noting that a decent chunk of its percentage can
likely be attributed to faculty practices in hospital systems.
Thus, if we're tracking physicians in practice, the numbers are
probably not as lopsided in favor of Epic.
In terms of the number of dermatologists who received
incentives, there are several factors worth considering as we
try to extrapolate meaning from the data. Indeed, 518 is not
a particularly high number. On the positive side, given the
somewhat chaotic ride before we arrived at a final ruling on
Meaningful Use, that 500-plus physicians from our specialty
have pursued incentives can be viewed as something of an
accomplishment. Furthermore, these numbers, in all likelihood,
indicate that most dermatologists who received 2011
incentive dollars were already using an EHR before the incentives
went into effect. Thus, the data likely do not reflect the
flurry of interest and pursuit of the various EHR vendors over
the course of this year and last. Given the shifting conditions
of the EHR market, the percentage distribution of vendors
will likely undergo significant changes from 2011 to 2012.
It also bears mentioning that users have until October 1 of
this year to begin qualifying for Stage 1 and be eligible for the
entire $44,000 in incentives; It would also be reasonable to
expect that next year's numbers of total users will see a jump
from those of this year.
Moving Forward
How you view the total number of meaningful users within
dermatology will likely determine your current sensibility
toward EHRs. The real number that matters is one we haven't
seen yet: the data for 2012 (available sometime in the first
half of 2013). The rate of increase per year among meaningful
users is going to be the telling story of the role EHRs will fulfill
in dermatology. The current number can therefore be interpreted
as baseline. Most of those who plan to attest were not
prepared to attest in 2011 and probably have begun this year
to meet the October 1 deadline.
Mark Kaufmann, MD is co-chair of the
Dermatology work-group for CCHIT. He is on the
Medical Advisory Board of Modernizing Medicine.