The mid-year data on the Electronic Health Record (EHR) Incentive Program (Meaningful Use) has been released, allowing further insight into adoption of EHRs. The current year-to-date Meaningful Use attestation figures can be compared to 2011 data, and can illustrate vendor-specific trends in adoption.
A few points about Meaningful Use need to be made here. All the data so far represents clinicians who are attesting for the first time. During the first year of attestation in the Medicare program, an EHR only needs to be used for 90 consecutive days; in subsequent years, the EHR needs to be used for the full calendar year. That means that all of the 2012 attestation data to date represents first-time users – those who attested in 2011 will only be eligible to attest for their second year in the program at the end of 2012 (in January and February of 2013).
Those who were using their EHRs and attesting for 2011 activity had until the end of February to get their attestations in. Those who didn’t get their 90-day period completed by the end of 2011 could begin their attestation in 2012 once 90 days in 2012 had elapsed (using January-March as their earliest 90-day attestation period). As a result, the attestation figures show a drop to near-zero in March, with earliest attesters in 2012 starting to show beginning in April.
Ambulatory EHR use
On the ambulatory side of the ledger, as we saw in 2011, the top 17 vendors constituted 77% of all attestations, with the remaining 23% percent of attesters being distributed among products from 323 vendors. This pattern has not changed since last year, though there are some vendors used by one (or a few) attesters in 2012 that had no traffic in 2011.
The month-by-month performance by each of the top 17 vendors, which represent the bulk of ambulatory EHR attestation activity, sheds some light on how clinicians are engaging the Meaningful Use program:
The peak months represent either concerted “pushes” by systems and hospital-associated clinics (as is the case with Epic users, since this vendor focuses on hospitals and their tethered clinics, and does not market directly to independent physicians), or pushes by vendors encouraging their users to attest (especially hosted systems, such as Practice Fusion and athenahealth).
Hospital EHR use
On the hospital side, there is similar concentration among vendors, though this is shifting a bit more in 2012. In 2011, 72% of hospital attestations were concentrated among the top 5 vendors, whereas in 2012, these top 5 vendors constitute only 56% of all attestations to date.
The month-by-month pattern for hospitals show that all hospitals who were going to attest in 2011 did so by November; basically no hospitals did their attestation in December. In 2012 (still all in their first program year; no one has attested for their second program year either on the ambulatory or the hospital side), the pattern looks different:
The mid-year snapshot of Meaningful Use attestations shows a continuation of much of the same dominance by a handful of vendors in the space. The current data all represent first-time attesters, since the full 2012 year has not yet elapsed and therefore first-time attesters in 2011 have not had the 12-month second-year time needed for second-year attestation. In January and February of 2013 is when we will see the bulk of second-year attestations for 2012, after the full calendar year has elapsed.