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Calif. Doctors Adopting EHRs, Not Always Meeting Meaningful Use Rules


Cost, lack of education, lack of certified EHRs cited as factors for halfhearted embrace of state, federal programs.

California physicians don’t lack love for EHRs and other medical practice technology. But when it comes to meeting CMS’ meaningful use requirements to score financial EHR incentives, far fewer docs are on board. 

A recently released report from California HealthCare Foundation, based on 5,384 California physicians who are eligible for Medicare or Medicaid EHR incentive payments, revealed that while 71 percent of respondents report having an EHR at their main practice location, only 30 percent can achieve 12 Stage 1 meaningful use objectives (the survey asked about the availability of functions needed to achieve eight of the 15 core meaningful use measures and four of the 10 menu objectives established by CMS).

Furthermore, the survey indicated that just 37 percent of physicians plan to apply for either Medi-Cal (which runs the state’s Medicaid program) or Medicare incentive program.

The study’s findings are a bit perplexing. It’s not like $44,000-plus in incentives is money to laugh at.

Apparently, upfront costs are a bigger issue than one might think.

In a recent interview we did with Dorian Seamster, chief of health information services for CalHIPSO, one of three regional extension centers representing California practices, cost was cited as a big challenge for many physicians who want to adopt EHRs. As a result, the organization plans to contract with a number of cloud-based EHR providers in the near future, which offer monthly subscription plans in lieu of steep, fixed costs for hardware and software.

And for those practices who already purchased an EHR pre-meaningful use requirements, upgrading it so it’s certified isn’t necessarily a cheap endeavor. The cost can exceed $10,000, according to many physicians we’ve interviewed.

Researchers also suggest that more docs aren’t trying to score meaningful use incentive money because a lot of the EHRs available to them aren’t configured to meet core objectives. Rates of availability are lowest among physicians who work in solo practices, small partnerships, and community/public clinics, according to the study. Also, office-based physicians are less likely to have EHRs than hospital-based physicians, and rural physicians are less likely to have them than urban physicians.

Researchers suggested four courses of action to improve EHR incentive program buy-in, starting with making efforts to educate physicians about the eligibility criteria for Medi-Cal incentive payments and encouraging eligible physicians to apply.


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