Crossing the Last Mile of EHR Adoption

Making Clinical Support Tools Accessible to All

John Squire, President and COO, Amazing Charts.com, LLC

According to the Great American Physician Survey 2013, only about 50 percent of private practices with five or fewer physicians report having an Electronic Health Record (EHR) system today.[1] This means that these practices don’t have access to Information Technology (IT) tools – knowledge-based clinical decision support systems that work in real time; evidence-based health maintenance reminders; patient panel analytics – that can help them deliver better healthcare to patients.

In the past, access to such resources was restricted to a few select clinicians and their patients at well-funded private clinics and health systems, such as the Cleveland Clinic, the Mayo Clinic, and Massachusetts General Hospital. The patients of primary care physicians in the small, private-practices setting did not always have access to the best possible healthcare services.

EHRs Trigger a Revolution

The good news is that the landscape is changing, and rapidly. As the spread of EHR systems expands access to clinical support tools for practices of all sizes, a “democratization” effect is underway whereby new technology enjoyed by the few has become accessible to the many. This is supported by price reductions, disruptive business models, and government subsidies, such as the HITECH Act of 2009 and Meaningful Use incentives.

Today, we are experiencing a healthcare delivery revolution thanks in large part to open access to relevant medical knowledge at the point of care, which leads to better patient outcomes. But there is still plenty of work to do.

Historically, EHR adoption rates have fallen when moving down the size curve from hospitals, to large group practices, to small and solo practices; therefore, the next challenge is to get more of the smaller practices to adopt an EHR system. We call it the “last mile” of EHR adoption.

Setting the Pace for the “Last Mile”

One way to address the “last mile” challenge is to continue expanding access to new clinical support tools.

This reimagined EHR will take a problem-based approach to patient encounters. The goals are to reveal patterns and provide insights that help physicians make more accurate diagnoses, create more effective treatment plans, adjust current medications, and more.

This new EHR will also integrate with continuing medical education (CME) resources and learning activities to bring the latest global medical knowledge to physicians’ fingertips.

Finally, intuitive data analytics will play a critical role by helping physicians measure, assess, and manage their specific patient populations. Physicians can mine EHR data to better define specific gaps in clinical care, such as the percentage of patients with diabetes who do not meet current HbA1C target goals. The same data creates prescriptive education and resources to improve these metrics by introducing the latest evidenced-based treatment procedures or diagnostic techniques.

All of these advanced technology tools will become available to primary care physicians at small practices at an affordable cost, making the last mile of EHR adoption an easier sprint to the finish line.


[1] http://www.slideshare.net/kareo/great-american-physician-survey-2013