Table 2.
Eligible providers’ EHR behavior
| Median per provider (25th percentile–75th percentile) | Jan–Jun 2013 only | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Metric | All years* | 2010 | 2011 | 2012 | Jan–Jun 2013 | p for trend | MU providers | Non-MU providers | p value |
| No. providers | 112 | 55 | 70 | 90 | 87 | 41† | 46 | ||
| Data access | |||||||||
| % Of encounters per provider with | |||||||||
| Problem list marked as reviewed | 9.4 (3.8–15.5) | 5.1 (0.9–19.9) | 7.5 (1.6–13.7) | 7.4 (1.9–11.3) | 7.5 (4.2–14.6) | 0.72 | 6.0 (3.7–10.0) | 10.7 (6.8–20.7) | 0.002 |
| Medication list marked as reviewed | 5.8 (2.4–15.5) | 2.3 (0.1–10.9) | 4.0 (0.7–11.1) | 4.9 (1.6–10.4) | 8.9 (4.5–15.3) | 0.05 | 8.2 (3.6–11.0) | 10.4 (5.2–17.1) | 0.09 |
| Allergies marked as reviewed | 81.0 (73.3–85.1) | 78.9 (71.6–82.8) | 82.3 (75.2–86.9) | 81.9 (73.0–87.6) | 81.1 (73.7–86.0) | 0.28 | 81.3 (73.3–86.6) | 80.5 (73.7–85.9) | 0.93 |
| Problem list altered | 23.6 (17.1–30.0) | 19.5 (14.7–24.1) | 23.0 (17.1–27.7) | 22.2 (16.6–29.7) | 25.0 (17.3–33.2) | 0.002 | 22.8 (16.9–33.3) | 27.7 (20.6–32.3) | 0.39 |
| ≥1 problem added | 23.6 (17.1–30.0) | 19.5 (14.7–24.1) | 23.0 (17.1–27.7) | 22.2 (16.6–29.7) | 25.0 (17.3–32.8) | 0.002 | 22.7 (16.9–32.8) | 27.6 (20.6–32.3) | 0.39 |
| ≥1 problem replaced | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.07 | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.75 |
| ≥1 problem dropped | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.39 | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.36 |
| Days to review laboratory results | 4.4 (2.9–7.4) | 4.9 (3.0–8.5) | 5.3 (3.0–9.8) | 4.1 (2.8–7.5) | 4.0 (2.5–5.9) | 0.01 | 4.0 (2.4–5.8) | 4.0 (2.5–5.9) | 0.59 |
| Clinical decision support measures | |||||||||
| % Best-practice alerts ‘accepted’ | 17.7 (9.4–24.6) | 18.6 (13.0–27.0) | 19.6 (12.6–30.0) | 20.9 (10.7–30.0) | 18.6 (10.4–26.0) | 0.91 | 22.5 (13.8–28.4) | 16.7 (8.6–24.4) | 0.03 |
| % Prescribing alerts ‘accepted’ | 0.1 (0.0–0.2) | 0.0 (0.0–0.3) | 0.0 (0.0–0.3) | 0.0 (0.0–0.2) | 0.0 (0.0–0.1) | 0.11 | 0.0 (0.0–0.1) | 0.0 (0.0–0.1) | 0.91 |
| Drug–allergy alerts | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT |
| Drug–disease alerts | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT |
| Drug–drug interaction alerts | 0.1 (0.0–0.3) | 0.0 (0.0–0.4) | 0.0 (0.0–0.4) | 0.0 (0.0–0.2) | 0.0 (0.0–0.2) | NT | 0.0 (0.0–0.1) | 0.0 (0.0–0.2) | NT |
| Drug–food alerts | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | NT |
| Ordering | |||||||||
| Laboratory tests ordered per encounter | 1.0 (0.7–1.4) | 0.7 (0.4–0.9) | 0.8 (0.5–1.1) | 1.2 (0.8–1.5) | 1.2 (0.9–1.6) | <0.001 | 1.2 (0.7–1.6) | 1.3 (0.9–1.6) | 0.44 |
| Number of order set uses per encounter | 1.1 (0.8–1.4) | 1.1 (0.9–1.4) | 1.1 (0.9–1.6) | 1.1 (0.8–1.5) | 1.1 (0.8–1.3) | 0.61 | 1.1 (0.8–1.3) | 1.0 (0.8–1.3) | 0.36 |
| Care coordination measures | |||||||||
| % Encounters with after-visit summary printed | 59.2 (26.9–83.6) | 10.8 (3.2–33.5) | 47.8 (21.3–74.2) | 73.1 (28.6–90.9) | 89.5 (67.1–96.0) | <0.001 | 94.9 (89.5–97.6) | 72.7 (37.0–90.8) | <0.001 |
| Patients messaged/month | 1 (0–3) | 1 (0–3) | 1 (1–4) | 1 (0–4) | 1 (0–4) | 0.53 | 1 (0–5) | 1 (0–3) | 0.16 |
| Provider-initiated messages/month | 1 (0–4) | 2 (0–4) | 1 (1–5) | 1 (0–4) | 1 (0–4) | 0.46 | 1 (0–6) | 1 (0–3) | 0.20 |
| % Patient-initiated messages responded to | 100 (98–100) | 100 (100–100) | 100 (99–100) | 100 (98–100) | 100 (99–100) | 0.12 | 100 (94–100) | 100 (100–100) | 0.35 |
| % Of patient panel using portal during year | 6.9 (3.6–13.2) | 11.3 (6.4–26.1) | 10.8 (5.2–19.9) | 8.2 (4.0–14.3) | 6.0 (2.8–11.5) | <0.001‡ | 6.8 (3.8–14.5) | 4.9 (2.5–11.3) | 0.14 |
| % Of portal users using portal ≥15 times/year | 57.6 (51.6–64.7) | 55.3 (50.9–65.6) | 59.8 (53.2–67.1) | 64.4 (54.3–72.1) | 54.7 (43.8–66.0) | 0.001‡ | 50.0 (41.8–58.8) | 57.2 (48.2–66.7) | 0.08 |
| Population/panel level | |||||||||
| Viewed panel-level reports (median number of views) | 0.0 (0.0–3.8) | NA | 0.0 (0.0–5.0) | 0.0 (0.0–5.0) | 0.0 (0.0–1.0) | 0.43 | 0.0 (0.0–3.0) | 0.0 (0.0–0.0) | 0.01 |
| MU objective measures§ | |||||||||
| Core | |||||||||
| Core 1—CPOE | 100 (99–100) | NA | 100 (99–100) | 100 (99–100) | 100 (99–100) | DNC | 100 (100–100) | 100 (99–100) | 0.42 |
| Core 3—Problem list | 97 (95–98) | NA | 96 (95–97) | 97 (95–98) | 98 (96–99) | 0.02 | 98 (97–99) | 98 (95–99) | 0.51 |
| Core 4—E-prescribing | 68 (40–84) | NA | 71 (44–84) | 75 (46–87) | 76 (50–87) | 0.26 | 77 (64–88) | 68 (37–86) | 0.03 |
| Core 5—Medication list | 96 (93–97) | NA | 95 (93–97) | 95 (94–97) | 97 (95–98) | 0.01 | 97 (95–98) | 97 (95–98) | 0.67 |
| Core 6—Allergy list | 99 (99–100) | NA | 99 (99–100) | 99 (99–100) | 99 (99–100) | 0.17 | 99 (99–100) | 99 (99–100) | 0.44 |
| Core 7—Demographics recorded | 94 (91–97) | NA | 94 (91–96) | 94 (91–96) | 95 (91–97) | 0.43 | 96 (93–97) | 95 (91–97) | 0.94 |
| Core 8—Vitals recorded | 97 (96–98) | NA | 97 (96–98) | 98 (97–98) | 98 (97–98) | <0.001 | 98 (97–98) | 98 (97–98) | 0.79 |
| Core 9—Smoking status recorded | 98 (97–99) | NA | 98 (96–99) | 99 (98–99) | 99 (98–99) | 0.75 | 99 (98–99) | 98 (97–99) | 0.36 |
| Core 11—Patient copy of health information | 100 (100–100) | NA | –¶ | –¶ | 100 (100–100) | NT | 100 (100–100) | 100 (100–100) | >0.99 |
| Core 12—After-visit summary | 63 (33–78) | NA | 42 (28–64) | 64 (31–81) | 72 (49–84) | <0.001 | 77 (66–85) | 65 (38–81) | 0.01 |
| Menu | |||||||||
| Menu 7—Timely access to data for patients | 83 (76–90) | NA | 73 (70–79) | 81 (77–87) | 91 (84–98) | <0.001 | 85 (83–91) | 95 (88–100) | <0.001 |
| Menu 8—Patient education | 65 (57–75) | NA | 56 (47–66) | 69 (60–79) | 73 (64–81) | <0.001 | 77 (69–85) | 70 (60–75) | 0.001 |
| Menu 9—Medication reconciliation | 15 (8–29) | NA | 10 (3–19) | 13 (5–27) | 21 (11–38) | <0.001 | 18 (9–35) | 25 (13–48) | 0.18 |
| Menu 10—Summary of care at transitions | 77 (36–91) | NA | 51 (25–78) | 80 (39–94) | 85 (58–97) | <0.001 | 92 (80–97) | 70 (34–95) | 0.01 |
For definitions of ‘accepted’ for best-practice alerts and prescribing alerts, please see the Methods section.
*Pooled results across all years are reported, except for panel-level reports and MU measures, for which weighted averages are reported.
†Although 42 providers attested at the end of 2012, one did not contribute data to the 2013 data set and is excluded from this comparison.
‡Comparisons do not include 2013 data as half-year results would not be expected to be similar to full-year results.
§Percentage of patients for whom metric was met, except for e-prescribing metric, which is calculated as a percentage of prescriptions. Core 2, 10, and 13 were accomplished at the organizational level and are not included as they do not vary by provider.
¶No provider had data for this measure in 2011 or 2012.
CPOE, computerized provider order entry; DNC, (model) did not converge; EHR, electronic health record; MU, meaningful use; NA, not available; NT, not tested.