Physicians’ Exchange of Clinical Data Capabilities Vary, ONC Study Reveals

October 25, 2013
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A new study, conducted by the Office of the National Coordinator for Health Information Technology (ONC) researchers, detailed the effectiveness with which office-based physicians are exchanging lab and medication data.

The research, which appeared in the American Journal of Managed Care, looked at how physicians were to electronically sharing clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors. They used data from a 2011 survey of physicians for the study, with 4326 responding.

Of the findings, one of the more interesting pieces was the overall capability of all physicians (55 percent) to send prescriptions electronically. For those physicians with an EHR, the number was up to 78 percent. There were similar disparities between all physicians and those who used an EHR:

  • 67 percent of all physicians could view electronic lab results vs. 87 percent of physicians with an EHR.
  • 42 percent could incorporate lab results into their EHR vs. 73 percent of physicians with an EHR.
  • 38 percent could provide clinical summaries to patients vs. 61 percent of physicians with an EHR.
  • 31 percent exchanged patient clinical summaries with another provider vs. 49 percent of physicians with an EHR.

“The results of this study are encouraging because they show that a majority of physicians who use EHRs can electronically exchange test results, medication data and clinical care summaries with patients, all of which are integral to better care coordination and ultimately necessary for universal interoperability,” Vaishali Patel, an ONC senior advisor and lead author of the study, said in a statement.

“As Stage 2 of Meaningful Use moves forward, it will be important to continue monitoring physicians’ exchange capabilities and actual exchange activity to ensure that health information follows the patient wherever they go."

Perhaps the most important focus on variation was around EHR vendors. Between 73 percent and 94 percent of physicians using an EHR reported that they possess the capability to eprescribe depending upon their vendor. The largest discrepancy was with physicians’ capability to send lab orders electronically, which ranged from more than one-third (38 percent) to 87 percent depending upon the EHR vendor.

There was significant variation among physician exchange capability at the state-level, the researchers found. Massachusetts, Minnesota, North Dakota, Oregon, Vermont, Wisconsin, and Washington reported significantly higher than the national average across at least 4 out of the 6 measures of exchange. Louisiana, Nevada, and New Jersey have significantly lower rates of physician reported exchange capability across at least 4 out of the 6 measures.

Another varying factor was practice size and ownership. Practices owned by health maintenance organizations or healthcare corporations were significantly more likely to exchange all 6 types of clinical data compared with physician-owned or physician group–owned practices. Larger practice size was associated with the capability to conduct all facets of electronic lab exchange, the researchers found.

Overall, the researchers say this is a baseline study of physician capability to exchange key types of clinical information. They said there was room for improvement but also a foundation on which to build and expand physician exchange capability.

It’s the second ONC-sponsored study within the course of a month. A few weeks ago, the ONC researchers released encouraging data for advocates of the meaningful use program.

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