Final A Gurvey Report V4 Ppt
- 1. E lectr ic H ealth R ecor s: on d Keys to Ach ievin g Value an d I p r g C ar m ovin e
- 2. About th e Survey During Q2 2009, the American Medical Group Association (AMGA) conducted a survey with the help of the JHD Group, a physician practice management, office technologies, and healthcare management consulting firm. This survey included AMGA members and non-members and was designed to understand the experience of physicians and mid- levels regarding the implementation and utilization of Electronic Health Record and Practice Management systems, with a particular focus on identifying the key success factors to capturing the benefits offered by these critical tools. Survey invitations were sent to several senior leaders in each organization. The AMGA members were strongly interested in sharing their experiences, as evidenced by the 52% response rate from the 309 member organizations that submitted at least one response. At many of those groups, multiple leaders submitted responses. Additionally, 39 surveys were submitted by physicians and top administrators of large, non-member medical groups. This data provided a very rich sample from which to draw conclusions on the factors that distinguish groups that derive the greatest benefits from their EHRs from those that are still struggling to capture the potential value represented by these increasingly ubiquitous tools. 2
- 3. About AM G A an d J DG H The American Medical Group Association (AMGA) represents medical groups, including some of the nation's largest, most prestigious medical practices, independent practice associations, and integrated healthcare delivery systems. AMGA improves health care for patients by supporting multispecialty medical groups and other organized systems of care. The members of AMGA deliver health care to approximately 96 million patients in 49 states. Headquartered in Alexandria, Virginia, AMGA is the strategic partner for medical groups providing a comprehensive package of benefits, including political advocacy, educational and networking programs and publications, benchmarking data services, and financial and operations assistance. www.amga.org JHD Group is a leader in assisting physician organizations to meet the challenges of care delivery, managed care, technology, compliance, and patient services. The JHD Group focuses on driving the operational excellence and financial results that clients seek through their expert comprehensive clinical integration, management consulting, and practice management services. www.jhdgroup.com 3
- 4. Dem ogr h ics ap Responses to the survey primarily came from larger (+100 physician and midlevel FTE) groups that have been utilizing EHRs in their practices for 3 or more years. This 59% level of “long-term” (>3 years) EHR use is much higher than the rates reported by most of the surveys being published regarding EHR adoption among US physicians. It also reflects the position of the AMGA member organizations as industry leaders in information technology use, complemented by their historical and recognized leadership in clinical services. 4
- 5. E xecutive Sum m ar y Sever m aj th em es em er f om th e r on se d ata. al or ged r esp 1. H ealth car p r ession als view E H R s as both an im p or t tool an d a sign if tin vestm en t e of tan ican th atis cr itical to th e f e success ofth eirgr s. E xp ectation s ofth e ben ef ofer by utur oup its f ed E H R s ar both br an d d eep . Th ey in clud e sup p or g im p r e oad tin ovem en ts in clin ical q uality, p atien tser vice, op er ation al eficien cy, f an cial p eror an ce th r f in f m ough m an agin g r or isk cap tur g in cen tive r in even ues, an d m ar p osition . ket 2. Tod ay’E H R system s r uir substan tial tim e f tr in g, p lan n in g, an d custom iz s eq e or ain ation to m eetth e var n eed s ofd ifer t sp ecialties an d d ifer tly con f ed p r ied f en f en igur actices. Ad d ition ally, im p lem en tation ofan E H R system r uir substan tial in vestm en tabove an d eq es beyon d th e licen sin g an d tr in g costs in or erto d eliverth e f p oten tial.System ain d ull im p lem en tation s ar h igh ly d isr tive an d r e up esour - ten sive. Th ey sh ould be car ully ce in ef p lan n ed to en sur a successf laun ch . e ul 3. C ap tur g th e p oten tial ben ef f om an E H R is an on goin g efor an d even th e m ost in its r f t successf user h ave cap tur on ly a p ar ofth eirexp ected an d d esir ben ef Th ese ul s ed t ed its. ben ef on ly r its esult af wor low r esign , ad j ter kf ed ustm en ts to th e d ivision oflaborstaf / f utilization , an d exp an d in g utilization ofth e system cap abilities. 4. E xp er ce br s op tim ism . G r s alm ostun iver ien eed oup sally r or in cr ep t eased exp ectation s f or th e value d eliver by E M R system s acr a var off ed oss iety eatur an d f ction s, even bef e es un or th ose gr s h ave cap tur th e ben ef th ey exp ected th e system s to d eliverp r to oup ed its ior Optimism im p lem en tation . 1. O n goin g ed ucation an d tr in g is cr ain itical to r in g th e ben ef ofer by E H R s. E ven am on g gr s with selfr ealiz its f ed oup -ated h igh ach ievem en tan d h igh exp ectation s ofth eirsystem s, th er r ain s con f e em usion (in clud in g at th e lead er ip level)ofwh at th eirsystem s sh ar curen tly cap able ofd eliver g to th e gr s. e r in oup 2. Patien ce an d p ersisten ce ar am on g th e m ostcr e itical success f actor Th e gr s cap tur g th e m ostben ef f om th eirE H R system s s. oup in its r ar th ose wh o in tr uce f ction ality in stages, allow tim e f th e p h ysician s an d staf to d evelop p r icien cy in subsets ofcap abilities e od un or f of at a p ace th ey ar able to absor an d p lan car ully f th e r e b, ef or ollout/exten sion ofsystem f ction ality. G r s with th e gr atest/ gest un oup e lon exp er ce with th e system s (e. , >5 year ar also th ose with th e gr ien g. s) e eatestsuccess in cap tur g ben ef an d satisf in its action with th eir E H R system s. 5
- 6. O p er ation s an d Q uality Has your practice experienced any of the following changes in healthcare delivery that can be attributed in part or in full to use of an EHR? (check all that apply) 0 20 40 60 80 1 00 1 20 In tra- e com m s m ore effic ien t/ reliable offic M ore flexibility/ rem ote ac c ess Patien t problem s addressed m ore effic ien tly eRx = reduc ed call bac k s from ph arm ac ies E& M codin g is m ore ac c urate eRX = avoidin g adverse drug ev ts en Ch ron ic disease rem in ders/ m an agem en t Better c h arge capture O th er 6
- 7. E volution M od el Ben ef an d Value its ch an ge an d in cr ease in com p lexity over tim e 7
- 8. M ean in gf U se ul Dem an d s ofgover m en t an d p ayerp r am s will in cr n ogr ease an d becom e m or com p lex overtim e e HIT Enabled Health Reform 8
- 9. Poten tial U p Sid e E xam p le:a 20 0 p h ysician gr r p up to ach ieve “ m ean in gf use” oup am ul Number of Physicians Effectively Using EHR Payment Year 2011 2012 2013 Total 80 80 HIT Enabled Health Reform 40 200 2011 $1,440,000 $1,440,000 2012 960,000 $1,440,000 $2,400,000 2013 640,000 960,000 600,000 $2,200,000 2014 320,000 640,000 480,000 $1,440,000 2015 160,000 320,000 320,000 $800,000 2016 160,000 160,000 $320,000 $3,520,000 $3,520,000 $1,560,000 $8,600,000 9
- 10. E H R I tegr n ation The majority of respondents indicated that their EHR systems were integrated with a Practice Management system. The majority of respondents do utilize ePrescribing and most programs are integrated with the EHR. Slightly more than half of respondents do utilize a Patient Registry, but only a third have an integrated capability. eRx in tegrated w ith EHR Patien t Registry in tegrated w ith EHR 140 133 140 120 120 10 0 10 0 80 80 64 64 60 60 47 42 40 40 18 17 20 20 1 0 0 Don ’ N o Pt. Yes but n ot t Yes but n ot No y eR x Don ’Kn ow Kn ow R egistr ated ated Yes an d ated ated Yes an d in tegr in tegr in tegr in tegr t 10
- 11. Data C ap tur e The survey results and follow-up interviews clearly indicate that the ability to access extensive patient data quickly is an early and significant benefit from implementing an EHR. This observation is supported by the fact that multiple data sets are currently being captured in most EHR systems. E xter al sp ecialist r eral r ts n ef r p I tr or n a- gtaskin g d ata I ter al sp ecialist r eral r or n n ef r ep ts R ad iology/m agin g tests I C lin ical n otes Patien t p r oblem , m ed s, aller lists gies L abor y tests ator Patien t d em ogr h ics d ata ap 0% 20 % 40 % 6 0% 80 % 10 0 % C ap tur g tod ay in Plan to cap tur w/ 2 yr e in s Plan to cap tur w/ 5 yr e in s N o p lan s to cap tur e 11
- 12. Sh ar g C om p utable Data in We wanted to understand whether systems were simply sharing data in a digitized format, like a pdf, or whether they were transmitting computable data that could be manipulated in the EHR system. Survey results indicate that laboratory information has a high level of computability, followed by radiology reports and pharmacy records. Hospital inpatient and discharge information is not generally transmitted in a computable form. Hospitals - h arge data disc Hospitals - patien t data in Ph arm ac y Radiology Labs 0% 1 0% 20% 30% 40% 50% 60% 70% 80% 90% 1 00% 12
- 13. U se ofE H R Data One of the widely heralded features of an EHR is the ability to report data that can be used to meet payer, government ,or internal performance guidelines. More than half the respondents indicated that they are currently using their output to support improved coding, incentive programs, patient case management, and adherence to protocols. More than 95% do so now or plan to do so within 2 years. About a quarter of respondents were using their output for more complicated programs such as demonstrating clinical cost effectiveness, looking at longitudinal patient data, or clinical research and trials. Fewer than 10% are currently able to do evidence-based predictive modeling and more than 40% plan to wait 5 years or have no plans to do so. P4P,PQRI,HED IS etc . Im prov g c lin icalcodin g in Clin icalguidelin es an d/ or protocols In dividualpatien t case m an agem en t Clin icaltrials or researc h Lon gitudin alv s of patien ts an d population s iew D em on stratin g c lin icalcost effec tiv ess en Ev c e- iden based predic tiv m odelin g e 0% 20 % 40 % 6 0% 80 % 10 0 % U sin g tod ay Plan to use w/ 2 yr in s Plan to use w/ 5 yr in s N o p lan s to use 13
- 14. Str ategic I p or ce ofE H R m tan Surprisingly, while garnering incentives is a strategic imperative for nearly 40% of respondents, quality, efficiency, and service are rated as much more critically important to these organizations. In fact, market positioning for providers was rated as slightly more important than incentive revenues. R isk orin cen tive r even ue M ar p osition ket Patien t ser vice O p er ation al eficien cy f C lin ical q uality 0% 20 % 40 % 6 0% 80 % 10 0 % Cr itically im p or t tan I p or t m tan N eutr al L ow im p or ce tan N ot im p or t tan 14
- 15. E xp ectation s v.R esults Respondents were asked to indicate the level of expectations for various benefit categories shown below. The inquiry explored expectations from the start of implementation, how much they felt they had achieved at the time they responded to the survey, and what their ultimate level of expectations were at the time of the survey. Overall, expectations across all categories were highest to high going in to an EHR implementation and as the implementations continued or were completed, expectations actually rose significantly for future achievement of benefits. BetterAccess to M ed ical R ecor s d BetterPatien t Follow up Full p ictur ofth e p atien t e R ed uction in M ed ical E ror r s I pr m oved coor in ation ofcar an d r erals d e ef r Betterability to p lan an d execute in ter tion ven I pr m oved M D p atien t com m un ication I pr m oved case/ igh r m an agem en t h isk I pr m oved use ofguid elin es an d p r otocols Dem on str ated C lin ical C ost efectiven ess f I pr m oved r or g ofp atien t com p lian ce ep tin Lowest Low Med Hi Highest Pre Implementation Expectations Current Expectations for Future Achieved at Time of Survey 15 Ford etailed r esults see ap p en d ix
- 16. C on clusion s § Work toward a team model that gets everyone working at the top of their licensure including physicians § Focus on clinical outcomes § Invested the time and resources required § Maintain a persistent focus on fully integrating the emerging system 16
- 17. Ap p en d ix 17
- 18. All R esp on ses 1. How many FTE providers (physicians and mid-level's) are in your organization? Value Count Percent 101 - 250 87 0.37 51 - 100 51 0.22 251 - 500 37 0.16 > 500 32 0.14 21 - 50 20 0.09 Less than 20 8 0.03 Total Responses: 235 2. Does your organization use an Electronic Health Record (EHR) system? Value Count Percent Yes 201 0.86 No 34 0.14 Total Responses: 235 3. Does your organization plan to implement an EHR system in the future? Value Count Percent Yes, within 2 years 28 0.82 Yes, within 5 years 5 0.15 Not Sure 1 0.03 Total Responses: 34 4. When did your organization start to utilize your current Electronic Health Record (EHR) system? Value Count Percent 5-10 years ago 49 0.25 3-5 years ago 42 0.21 2-3 Years ago 33 0.17 1-2 years ago 29 0.15 More than 10 years 25 0.13 Less than 1 year ago 20 0.1 Total Responses: 198 18
- 19. All R esp on ses (C on t.) 5. Is your EHR integrated with a Practice Management System? Value Count Percent Yes 135 0.68 No 30 0.15 Not sure 8 0.04 Other 25 0.23 Total Responses: 198 6. Does your organization use a Patient Registry and if so, is it integrated with an EHR? Value Count Percent No, we do not use a Patient Registry 81 0.35 Yes, we use a Patient Registry and it IS integrated with an EHR 76 0.33 Yes, we use a Patient Registry but it is NOT integrated with an EHR 55 0.24 Not sure 21 0.09 Total Responses: 233 7. Does your organization use ePrescribing capabilities and if so, are they integrated with an EHR? Value Count Percent Yes, we use ePrescribing and it IS integrated with an EHR 159 0.68 No, we don't use ePrescribing 53 0.23 Yes, we use ePrescribing but it is NOT integrated with an EHR 20 0.09 Not sure 3 0.01 Total Responses: 235 8. Does your ePrescribing capability address requirements for Medicare 2009 e -Prescribing incentive program such as the following: (check all that apply) Value Count Percent Ability to select medicines, print prescriptions, electronically transmit prescriptions, and conduct all alerts 158 0.91 Complete active medications list, incorporating data received electronically from pharmacies and pharmacy benefit managers (PBMs) 92 0.53 Ability to easily identify lower cost, therapeutically appropriate alternatives (e.g., tiered formulary information) 87 0.5 Patient specific concurrent formulary and authorization requirements (received electronically from PBM) 55 0.32 Other 17 0.17 Total Responses: 174 19
- 20. All R esp on ses (C on t.) 9. Does your EHR solution include any of the following? (check all that apply) Value Count Percent Patient portal / Secured patient communications 84 0.66 Physician portal (physician to physician) 84 0.66 Community Health Exchange 12 0.09 Other 10 0.1 Total Responses: 127 10. Does your Patient Portal give your patients the ability to: (check all that apply) Value Count Percent Request prescription refills 71 0.87 View lab results 59 0.72 Schedule appointments 46 0.56 Update their demographic information 45 0.55 Access a personal health record 43 0.52 Complete 1st time visit paperwork 32 0.39 Update their insurance information 29 0.35 Complete patient satisfaction surveys 12 0.15 Have access to formulary for patient benefit plan 4 0.05 Other 14 0.14 Total Responses: 82 11. Labs Value Count Percent Digital (computable) send and receive 143 0.76 Digital (computable) receive only 35 0.19 No digital interaction (uses fax, hard copies, etc.) 4 0.02 Digital (computable) send only 3 0.02 Don't know 2 0.01 Total Responses: 187 20
- 21. All R esp on ses (C on t.) 12. Radiology/Imaging Value Count Percent Digital (computable) send and receive 107 0.58 Digital (computable) receive only 41 0.22 No digital interaction (uses fax, hard copies, etc.) 20 0.11 Digital (computable) send only 12 0.06 Don't know 6 0.03 Total Responses: 186 13. Pharmacy Value Count Percent Digital (computable) send and receive 96 0.53 Digital (computable) send only 50 0.28 No digital interaction (uses fax, hard copies, etc.) 17 0.09 Digital (computable) receive only 10 0.06 Don't know 8 0.04 Total Responses: 181 14. Hospitals: for in-patient data Value Count Percent Digital (computable) receive only 60 0.34 No digital interaction (uses fax, hard copies, etc.) 58 0.33 Digital (computable) send and receive 47 0.27 Don't know 8 0.05 Digital (computable) send only 4 0.02 Total Responses: 177 15. Hospitals: for discharge notes Value Count Percent No digital interaction (uses fax, hard copies, etc.) 64 0.36 Digital (computable) receive only 59 0.33 Digital (computable) send and receive 41 0.23 Don't know 9 0.05 Digital (computable) send only 5 0.03 Total Responses: 178 21
- 22. All R esp on ses (C on t.) 16. Do you collaborate with Payors using your EHR in terms of: (check all that apply) Value Count Percent We do not collaborate with Payors using EHR 83 0.45 Excellence of Care incentives (P4P, value based reimbursement,etc) 76 0.42 Selected disease management programs 57 0.31 Case management for potential "high cost" conditions 25 0.14 Member/Patient Satisfaction 14 0.08 Other 16 0.16 Total Responses: 183 17. Has your EHR favorably impacted clinical workflow in the following categories: (check all that apply) Value Count Percent Across your delivery system - e.g.. multiple providers and/or multiple sites. 152 0.84 Around the individual provider(s) 129 0.72 Within the individual clinic(s) - e.g.. among all providers at a single site. 127 0.71 Other 18 0.18 Total Responses: 180 18. Do most of the users in your organization enter data via templates as opposed to relying on narrative or dictation entries in the "notes" fields? Value Count Percent Some use the templates, some enter narrative in the "notes" fields 103 0.57 Most use the templates most of the time 43 0.24 Most enter narrative in the "notes" fields 19 0.1 All use the templates nearly all of the time 10 0.05 Other, N/A 7 0.06 Total Responses: 182 22
- 23. All R esp on ses (C on t.) 19. Are you using, do you plan on using the EHR data to support: (check all that apply) Plan to use Plan to use within 2 within 5 No plans to Item Using today years years use Total P4P, PQRI, HEDIS and other quality/ incentive programs 110 67 5 1 183 Improving clinical coding 111 68 2 3 184 Demonstrating clinical cost effectiveness 46 96 17 22 181 Individual patient case management 90 80 9 4 183 Evidence based predictive modeling 16 88 36 38 178 Longitudinal views of patients and populations 49 72 33 27 181 Clinical guidelines and/or protocols 92 70 11 8 181 Clinical trials or research 68 45 23 43 179 Average % 40.1 40.4 9.4 10.1 1,450.0 Total Responses: 186 20. Are you routinely capturing, or do you plan on capturing the following data in digital (computable / structured) data form: (check all that apply) Plan to Plan to Capturing capture capture No plans to Item today within 2 yrs within 5 yrs capture Total Patient demographics data 182 3 1 186 Patient problem, medication, allergies lists (as a part of a structured patient care program) 174 11 1 186 Clinical notes 161 17 3 4 185 Laboratory tests 175 10 185 Radiology/Imaging tests 147 32 3 3 185 Internal specialist referral reports 132 40 3 8 183 External specialist referral reports 71 68 14 29 182 Intra-organizational tasking data 88 50 14 27 179 Average % 76.8 15.7 2.6 4.9 1,471.0 Total Responses: 186 23
- 24. All R esp on ses (C on t.) 21. Are you currently measuring return on investment (ROI) for your EHR system? Value Count Percent No, we don't formally measure ROI 88 0.51 Yes, and the measures are both qualitative and quantitative 37 0.21 Yes, and the measures are mainly quantitative 17 0.1 Yes, and the measures are mainly qualitative 13 0.08 Other 18 0.18 Total Responses: 173 22. Has your practice experienced any of the following changes in healthcare delivery that can be attributed in part or in full to use of an EHR? (check all that apply) Value Count Percent Intra-office communication is more efficient and/or more reliable (for example, as a result of phone note and work list features) 146 0.85 Physicians have more flexibility because test data and/or charting is available remotely 144 0.84 Patient problems are addressed more efficiently during office visits (for example, as a result of a better managed patient problem list) 125 0.73 E-prescribing has contributed to reduced call backs from pharmacies 120 0.7 E-prescribing has contributed to avoiding adverse drug events 99 0.58 E&M coding is more accurate 98 0.57 Chronic disease reminders have contributed to Chronic Disease management 86 0.5 Charges are captured more effectively 85 0.49 Other 13 0.13 Total Responses: 172 23. Do you have a process for improving the use/benefits of your EHR? Value Count Percent Yes 159 0.9 No 9 0.05 Not sure 9 0.05 Total Responses: 177 24
- 25. All R esp on ses (C on t.) For the following categories of EMR benefits, please indicate level of expectation in your organization for the following: (check all that apply) 24. Better access to medical records and/or patient data Value Count Percent 5 Expected Highest 120 0.75 4 Expected Hi 32 0.2 3 Expected Med 9 0.06 Total Responses: 161 25. Better access to medical records and/or patient data Value Count Percent 5 Achieved Highest 96 0.56 4 Achieved Hi 48 0.28 3 Achieved Med 22 0.13 1 Achieved Lowest 2 0.01 2 Achieved Low 2 0.01 Total Responses: 170 26. Better access to medical records and/or patient data Value Count Percent 5 Future Highest 121 0.82 4 Future Hi 21 0.14 3 Future Med 5 0.03 Total Responses: 147 27. Better/easier patient follow-up Value Count Percent 5 Expected Highest 76 0.48 4 Expected Hi 51 0.32 3 Expected Med 28 0.18 2 Expected Low 3 0.02 Total Responses: 158 25
- 26. All R esp on ses (C on t.) 28. Better/easier patient follow-up Value Count Percent 4 Achieved Hi 59 0.35 5 Achieved Highest 53 0.32 3 Achieved Med 44 0.26 2 Achieved Low 10 0.06 1 Achieved Lowest 1 0.01 Total Responses: 167 29. Better/easier patient follow-up Value Count Percent 5 Future Highest 99 0.67 4 Future Hi 37 0.25 3 Future Med 10 0.07 2 Future Low 2 0.01 Total Responses: 148 30. Reduction of medical errors Value Count Percent 5 Expected Highest 71 0.45 4 Expected Hi 52 0.33 3 Expected Med 26 0.16 2 Expected Low 6 0.04 1 Expected Lowest 3 0.02 Total Responses: 158 31. Reduction of medical errors Value Count Percent 4 Achieved Hi 61 0.38 3 Achieved Med 57 0.35 5 Achieved Highest 31 0.19 2 Achieved Low 10 0.06 1 Achieved Lowest 3 0.02 Total Responses: 162 26
- 27. All R esp on ses (C on t.) 32. Reduction of medical errors Value Count Percent 5 Future Highest 98 0.64 4 Future Hi 40 0.26 3 Future Med 12 0.08 1 Future Lowest 1 0.01 2 Future Low 1 0.01 Total Responses: 152 33. Full "picture" of the client Value Count Percent 5 Expected Highest 75 0.48 4 Expected Hi 44 0.28 3 Expected Med 30 0.19 2 Expected Low 5 0.03 1 Expected Lowest 2 0.01 Total Responses: 156 34. Full "picture" of the client Value Count Percent 4 Achieved Hi 62 0.38 3 Achieved Med 47 0.29 5 Achieved Highest 37 0.23 2 Achieved Low 10 0.06 1 Achieved Lowest 6 0.04 Total Responses: 162 35. Full "picture" of the client Value Count Percent 5 Future Highest 101 0.67 4 Future Hi 35 0.23 3 Future Med 12 0.08 2 Future Low 2 0.01 1 Future Lowest 1 0.01 Total Responses: 151 27
- 28. All R esp on ses (C on t.) 36. Improved physician-patient communication Value Count Percent 3 Expected Med 49 0.3082 4 Expected Hi 46 0.2893 5 Expected Highest 43 0.2704 2 Expected Low 16 0.1006 1 Expected Lowest 5 0.0314 Total Responses: 159 37. Improved physician-patient communication Value Count Percent 3 Achieved Med 75 0.4545 4 Achieved Hi 40 0.2424 2 Achieved Low 20 0.1212 5 Achieved Highest 20 0.1212 1 Achieved Lowest 10 0.0606 Total Responses: 165 38. Improved physician-patient communication Value Count Percent 5 Future Highest 71 0.4702 4 Future Hi 54 0.3576 3 Future Med 22 0.1457 1 Future Lowest 2 0.0132 2 Future Low 2 0.0132 Total Responses: 151 39. Better ability to plan and execute interventions Value Count Percent 4 Expected Hi 53 0.3464 3 Expected Med 43 0.281 5 Expected Highest 42 0.2745 2 Expected Low 11 0.0719 1 Expected Lowest 4 0.0261 Total Responses: 153 28
- 29. All R esp on ses (C on t.) 40. Better ability to plan and execute interventions Value Count Percent 3 Achieved Med 73 0.462 4 Achieved Hi 43 0.2722 5 Achieved Highest 17 0.1076 2 Achieved Low 16 0.1013 1 Achieved Lowest 9 0.057 Total Responses: 158 41. Better ability to plan and execute interventions Value Count Percent 5 Future Highest 67 0.4497 4 Future Hi 55 0.3691 3 Future Med 23 0.1544 1 Future Lowest 2 0.0134 2 Future Low 2 0.0134 Total Responses: 149 42. Improved coordination of care and referrals Value Count Percent 4 Expected Hi 57 0.3563 5 Expected Highest 52 0.325 3 Expected Med 44 0.275 2 Expected Low 4 0.025 1 Expected Lowest 3 0.0188 Total Responses: 160 43. Improved coordination of care and referrals Value Count Percent 4 Achieved Hi 62 0.369 3 Achieved Med 59 0.3512 5 Achieved Highest 28 0.1667 2 Achieved Low 13 0.0774 1 Achieved Lowest 6 0.0357 Total Responses: 168 29
- 30. All R esp on ses (C on t.) 44. Improved coordination of care and referrals Value Count Percent 5 Future Highest 83 0.557 4 Future Hi 49 0.3289 3 Future Med 14 0.094 2 Future Low 2 0.0134 1 Future Lowest 1 0.0067 Total Responses: 149 45. Improved case management/ high risk patient management Value Count Percent 4 Expected Hi 58 0.3766 5 Expected Highest 40 0.2597 3 Expected Med 33 0.2143 2 Expected Low 19 0.1234 1 Expected Lowest 4 0.026 Total Responses: 154 46. Improved case management/ high risk patient management Value Count Percent 3 Achieved Med 59 0.3758 4 Achieved Hi 42 0.2675 2 Achieved Low 33 0.2102 5 Achieved Highest 13 0.0828 1 Achieved Lowest 10 0.0637 Total Responses: 157 47. Improved case management/ high risk patient management Value Count Percent 5 Future Highest 80 0.5333 4 Future Hi 49 0.3267 3 Future Med 15 0.1 2 Future Low 6 0.04 Total Responses: 150 30
- 31. All R esp on ses (C on t.) 48. Improved reporting of patient compliance Value Count Percent 4 Expected Hi 51 0.3228 3 Expected Med 40 0.2532 5 Expected Highest 30 0.1899 2 Expected Low 25 0.1582 1 Expected Lowest 12 0.0759 Total Responses: 158 49. Improved reporting of patient compliance Value Count Percent 3 Achieved Med 59 0.3688 2 Achieved Low 40 0.25 4 Achieved Hi 34 0.2125 1 Achieved Lowest 20 0.125 5 Achieved Highest 7 0.0438 Total Responses: 160 50. Improved reporting of patient compliance Value Count Percent 5 Future Highest 56 0.366 4 Future Hi 48 0.3137 3 Future Med 32 0.2092 2 Future Low 14 0.0915 1 Future Lowest 3 0.0196 Total Responses: 153 51. Improved use of guidelines/protocols by providers Value Count Percent 4 Expected Hi 48 0.3097 5 Expected Highest 45 0.2903 3 Expected Med 43 0.2774 2 Expected Low 11 0.071 1 Expected Lowest 8 0.0516 Total Responses: 155 31
- 32. All R esp on ses (C on t.) 52. Improved use of guidelines/protocols by providers Value Count Percent 3 Achieved Med 58 0.3766 4 Achieved Hi 44 0.2857 2 Achieved Low 29 0.1883 1 Achieved Lowest 13 0.0844 5 Achieved Highest 10 0.0649 Total Responses: 154 53. Improved use of guidelines/protocols by providers Value Count Percent 5 Future Highest 84 0.549 4 Future Hi 47 0.3072 3 Future Med 20 0.1307 1 Future Lowest 2 0.0131 Total Responses: 153 54. Demonstrated clinical cost effectiveness Value Count Percent 4 Expected Hi 48 0.3038 3 Expected Med 46 0.2911 5 Expected Highest 38 0.2405 2 Expected Low 19 0.1203 1 Expected Lowest 7 0.0443 Total Responses: 158 55. Demonstrated clinical cost effectiveness Value Count Percent 3 Achieved Med 58 0.3694 4 Achieved Hi 39 0.2484 2 Achieved Low 36 0.2293 1 Achieved Lowest 16 0.1019 5 Achieved Highest 8 0.051 Total Responses: 157 32
- 33. All R esp on ses (C on t.) 56. Demonstrated clinical cost effectiveness Value Count Percent 5 Future Highest 66 0.4342 4 Future Hi 49 0.3224 3 Future Med 30 0.1974 2 Future Low 6 0.0395 1 Future Lowest 1 0.0066 Total Responses: 152 57. Are you currently addressing or do you have a plan to address the following? Item Yes No Total Establishing common policies, definitions and guidelines to reduce variation of practice 159 20 179 Managing information overload at the physician level 135 42 177 Redesigning the roles of physicians around EHR capabilities 145 34 179 Redesigning the roles of mid-levels around EHR capabilities 142 37 179 Redesigning the roles of clinical support around EHR capabilities 166 11 177 Average % 83.8 16.2 891 Total Responses: 180 33
- 34. All R esp on ses (C on t.) 58. How critical is your EHR to meeting your organizational goals for: Critically Low Not Item important Important Neutral importance Not important applicable Total Clinical quality 131 39 4 7 181 Patient service 91 72 10 4 4 181 Operational efficiency 110 52 12 3 3 180 Risk or incentive revenue 70 71 27 6 5 1 180 Market position 72 76 22 5 4 1 180 Average % 52.5 34.4 8.3 2 2.5 0.2 902 Total Responses: 181 59. Which of the following do you consider your most significant hurdles to implementing an EHR in the future? Significant Somewhat of Not Item Huge hurdle hurdle a hurdle Minor bump Not an issue applicable Total Board / leadership commitment 2 3 5 6 17 1 34 Physician resistance 2 5 15 7 5 34 Concerns about interoperability with other provider systems 3 9 13 6 3 34 Concerns about the value an EHR can really deliver 4 6 11 5 8 34 Cost/Investment 13 12 4 4 1 34 Other 2 1 5 8 Average % 14.6 20.2 27 15.7 19.1 3.4 178 Total Responses: 34 34
- 35. ForM or I f m ation e n or American Medical Group Association 1422 Duke Street Alexandria, VA 22314-3403 (703) 838-0033 / (703) 548-1890 fax www.amga.org JHD Group 5055 Keller Springs Road, Ste. 240 Addison, TX 75001 (972) 220-0474 www.jhdgroup.com 35