The Health Information Technology for Economic and Clinical Health (HITECH) Act — passed in 2009 to “promote the adoption and meaningful use of health information technology” — distributes billions in incentives to physicians to encourage implementation of certified electronic health records (EHRs) through its meaningful use (MU) program, with the ultimate goal of improving healthcare outcomes. In a recent study, Dr. Stephen T. Mennemeyer, professor in the department of health care organization and policy at the University of Alabama at Birmingham, examined to what extent the MU program has impacted the adoption of EHR. Co-investigators include DrPH recipient Dr. Saurabh Rahurkar, as well as Drs. Nir Menachemi, and Eric W. Ford, both formerly of UAB and currently at Indiana University and Johns Hopkins University, respectively.
According to Dr. Mennemeyer, “Bass and Gamma Shifted Gompertz (G/SG) diffusion models of the adoption of ‘Any’ and ‘Basic’ EHR systems in physicians’ offices using consistent data series covering 2001–2013 and 2006–2013, respectively, were estimated to determine if adoption was stimulated during either a PrePay (2009–2010) period of subsidy anticipation or a PostPay (2011–2013) period when payments were actually made.”
Results indicate that although an increase of up to 7 percentage points above the predicted level prior to the MU subsidies was detected upon the adoption of “Any” EHR system, this estimate has no statistical significance and in fact decreases under alternative model specifications. Dr. Mennemeyer adds, “No substantial effects were found for Basic systems. The models suggest that adoption was largely driven by ‘imitation’ effects as physicians mimic their peers’ technology use or respond to mandates. Small and often insignificant ‘innovation’ effects were found, suggesting little enthusiasm by physicians who are leaders in technology adoption.”
The investigators concluded that there is evidence of only weak impact made by the MU program, which is consistent with claims that many current EHR systems “reduce physician productivity, lack data-sharing capabilities, and need to incorporate other key interoperability features (e.g., application program interfaces).”
“Impact of the HITECH Act on Physicians’ Adoption of Electronic Health Records” was published online in July in the Journal of the American Medical Informatics Association.