Persistent EHR nonadoption could mean lower payment

(HealthDay)—Persistent nonadopters of electronic health records (EHRs) tend to be older, and are employed in smaller practices, according to a letter published in the March 3 issue of the Annals of Internal Medicine.

Catherine DesRoches, Ph.D., from Mathematica Policy Research in Cambridge, Mass., examined the correlation between EHR adoption and practice characteristics using a sample of 3,437 physicians in two waves (October 2011 to March 2012 and May to July 2013). Data were included from physicians who responded to both rounds of the survey (44 percent overall response rate).

DesRoches found that persistent nonadopters were older than other physicians, on average. The mean number of physicians employed in the main practice locations was 2.3 for persistent nonadopters, 33.4 for early adopters, and 15.1 for new adopters. Persistent nonadopters were more likely to be employed in independent solo or two-physician practices; early and new adopters were more likely to be employed by a hospital or medical school, network, or other type of health care organization. The primary compensation was fee-for-service for most persistent nonadopters and performance-adjusted salary for early and new adopters. Persistent nonadopters were less likely to participate in incentive programs focused on improving quality and continuity of care, and were less likely to receive additional payments for managing patients with chronic conditions or complex needs.

"Persistent nonadopters in small, isolated practices may be facing a unique set of challenges that limits their ability to adopt an EHR," DesRoches writes.

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