Comments on: HIStalk Practice Interviews Jeffery Daigrepont

By: Sanity Check

Sanity Check — Wed, 07 Apr 2010 02:57:29 +0000

OK, so you estimate that 30% of physicians have purchased EMR in pursuit of full use (coding, structured exam notes that stand up to audit, elimination of transcription, etc.) and only 5% have succeeded (that’s an 83% failure of EMRs to live up to physician expectations). For sure, meeting these expectations AND meeting onerous meaningful use requirements will result in a far greater failure rate – are we approaching EMRs failing to meet physician expectations more than 90% of the time?

By: Daigrepont

Daigrepont — Sat, 03 Apr 2010 23:08:19 +0000

Good question. I think (MY GUESS) is that there is about 30% who have purchase EMR, but only about 5% fully use it at the point of care. Some providers will report using an EMR, but they have a scribe or they only use a few features, but still dictate. I think future adoption will depend on the incentives going forward and % of medicare seen by a physician. I think once the penalties kick-in, those who delayed will start to take notice.

By: Sanity Check

Sanity Check — Sat, 03 Apr 2010 18:59:06 +0000

Jeffrey,

So if a tiny percentage of physicians fully use an EMR (you mention about 5% which a paltry number), then what will be the adoption success rate when physicians have to do even more work in the exam room to meet Meaningful Use Stage 1, Stage 2 and Stage 3 requirements?

By: Daigrepont

Daigrepont — Sat, 03 Apr 2010 14:56:05 +0000

It really depends on how adoption is defined. If you count adoption as full usage at the point of care, its likely less then 5%. Vendors count number of systems sold, but they usally do not go back and report on sold vs. installed, vs. actually used at the point of care. I have seen adoption stats range from 40% to 5%. If you asked do you have an EMR? You will get a much higher %. If you ask… do you have an EMR that conforms to CCHIT, has eRX, intergrated labs, used at the point of care with discrete data input, its much lower. Allscripts for example states 1 in every 3 physicians use Allscritps, but their numbers do not reflect 33% of all physicians in the USA. (The reason= they count all services,EDI, RCM, PM, eRX, etc… including past customers who have likely moved to something else)

By: Sanity Check

Sanity Check — Sat, 03 Apr 2010 14:14:47 +0000

Something doesn’t add up. Jeffrey states “I would say that if the vendors were totally honest, 20-25% of systems sold never get implemented.”

He then mentions that there are 600,000 to 700,000 physicians who can purchase an EMR and that his consulting firm “contacted every vendor that we possibly could, and by the time we contacted about 60 of them, the vendors had somehow managed to sell more EMR systems than there were physicians to buy them.”

So the vendors claim greater than 600,000 installed physicians and if, as Jeffrey says, 25% fail, then that means there are at least 450,000 physicians using EMR in the United States – we know that this level of adoption is not even close to reality! A real adoption rate of less than 10% means that, according to vendor numbers, 90% of EMR installations fail.