Who's who in eye care EHRs?

The federal government has recently made available for download a complete list of "CMS Medicare and Medicaid EHR Incentive Program, electronic health record products used for attestation". Bear in mind that these data are up to February 29, 2012 only. This was the date by which everyone who had attested for 2011 had to have completed their attestation. This means, therefore, that anyone who attested for a 90-day MU period in 2012 is not yet included. We know that this is a significant group over and above what's represented in the current report.


After a little data-crunching, here are some comments about the representation in eye care EHRs:

• optometrists are running just over double the numbers of ophthalmologists: 2,621 ODs versus 1,249 MDs
• the vast majority are using Complete EHR solutions versus Modular EHR solutions
• large numbers of both optometrists and ophthalmologists are in the ambulatory care settings of large health systems, as indicated by the software used
• the two dominant players in optometry, Compulink and Eyefinity, used primarily by independent ECPs, account for 66% of the optometry attestations and 11% of the ophthalmology attestations
• the three dominant players in ophthalmology, EpicCare, NextGen and Medflow, used primarily in health system settings, account for 48% of the ophthalmology attestations and 9% of the optometry attestations

Also of interest:

• modular solutions are most often used in hospital or ambulatory health system settings where one solution meets the clinical criteria and another serves for non-clinical or demographic criteria
• some modular solutions offered by e-prescribing vendors, such as Rcopia MU by DrFirst, are intended only as an interim step for Stage 1 MU and do not pretend to meet the long term clinical needs, for example, of eye care providers
• if we use 36,000 and 18,000 as approximate numbers for optometrists and ophthalmologists respectively, we can deduce that roughly 7.2% and 6.9% attested in 2011.

Takeaways:

• knowing that the train has well and truly left the station, as they say, we would expect the percentage of attestations for each group to rise to an estimated 20% in 2012
• knowing that most ophthalmologists are in health system settings (both ambulatory and in-patient), independent ECPs must take seriously the threat to their businesses as health system ACOs take more and more control over access to patients
• independent ECPs must now make a high priority of applying to their local ACOs to become part of the medical home chronic care teams.

Alistair Jackson, M.Ed.