- Conversations about EHR adoption and interoperability are often geared towards two major groups: primary care providers and hospitals. These organizations often function as the collection and distribution hubs for healthcare data, and their frequent contact with patients puts interoperability among their top must-have competencies.
But specialists do a great deal of the heavy lifting in healthcare, and need to have similar access to EHRs and other health information exchange options if they are to contribute their vital data to the care continuum.
Are health IT vendors, who may or may not offer tailored products for individual disciplines, paying enough attention to the unique needs of specialists? A new Black Book poll shows that the answer may be more complex than it appears at first blush. While some specialties may still be lagging behind primary care adoption rates, EHR vendors that offer strong interoperability capabilities are earning loyalty and market share. Can specialty-specific EHRs help connect more providers into networked care communities?
Office-based specialists have long remained behind the curve when it comes to EHR adoption, the Centers for Disease Control found in a 2014 study, with primary care EHR adoption outpacing specialists by close to ten percent in 2012. Certain specialists have had a difficult time qualifying for EHR Incentive Program funds, which may contribute to the widening adoption gap, and some have turned to a patchwork of health IT options or customizable software to create their own health IT infrastructure tailored to their needs.
But as Stage 3 meaningful use looms on the horizon, forcing more integration between primary care providers and other members of the care continuum, ensuring that specialists have interoperable EHR connections is becoming a financial imperative across the board.
Black Book Rankings previously identified dermatology as an area ripe for rapid EHR growth, and now asserts that orthopedics is seeing similar expansion as vendors begin to target their offerings to the increasingly eager specialty market.
More than three-quarters of the orthopedic profession is either live on an EHR or in the process of purchasing and implementing an electronic health record. Both first-time adopters and providers seeking an EHR replacement are turning towards fewer, more orthopedic-specific applications, the six-month user survey found. Fourteen percent of orthopedic surgery practices are in the market for an initial EHR system, while 17 percent of early adopters are on the hunt for a new health IT foundation.
"Product and vendor loyalty among several niche EHR specialists is on the upward trajectory," said Doug Brown, Black Book's managing partner. "The vendor's abilities to meet the evolving demands of interoperability, networking, mobile devices, accountable care, patient accessibility, customization for specialty workflow, and reimbursement are the main factors that the replacement mentality and late adoption are turning course in specialties such as orthopedic surgery."
"High performing vendors have emerged from the pack as practice implementations succeed and fail, meaningful use attestations are reviewed, and users assess their vendor's capabilities to meet their individual practice needs," added Brown.
These high performing vendors, which include both cloud-based and server-based offerings, balance their focus on interoperability with features that appeal to specialists, who often cater to lower volumes of patients with very complex needs. This group of providers may be more likely to desire integrated EHR and practice management technologies that help interoperability start at home while keeping a close eye on revenue cycle management, patient flow, and quality reporting.
Vendors are taking heed of this backlash against one-size-fits-all EHR products while simultaneously embracing the notion that healthcare data needs to flow across organizations in order to support emerging payment models, care coordination, and patient safety.
This combination of circumstances may make it easier for those specialists to choose discipline-specific EHR infrastructure that puts interoperability at the fore. As the specialty EHR adoption market continues to mature, orthopedists and others looking to join their primary care peers in the same interoperability ecosystem may have a growing number of top-shelf options from which to choose.