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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.

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