HealthDay News — The U.S. Department of Health & Human Services (HHS) recently announced that 2013 electronic health record implementation goals have already been met, but few clinicians say they are fulfilling the first stage of meaningful use criteria in a 2012 survey.

In March 2012, 43.5% of physicians who participated in the national survey said they had implemented basic EHR, an increase from 34% in 2011, but just 9.8% reported meeting meaningful use criteria, Catherine M. DesRoches, PhD, of Mathematica Policy Research in Cambridge, Mass., and colleagues reported in Annals of Internal Medicine.

Furthermore, managing patient populations with computerized systems was not widespread, with less than 50% of respondents reporting having a system for any of the patient population management tasks included in the survey.

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“Results support the growing evidence that using the basic data input capabilities of an EHR does not translate into the greater opportunity that these technologies promise,” the researchers wrote.

“Meaningful use” refers to a set of criteria set forth in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, that healthcare providers must meet to qualify for Medicare and Medicaid incentive payments. Those who meet the guidelines are eligible for up to $44,000 in incentive payments, but those who do not will be penalized beginning in 2015.

To assess progress toward meeting meaningful use criteria, DesRoches and colleagues conducted a national mailed survey of practicing primary care and office-based specialist physicians in the American Medical Association (AMA) Physician Masterfile from late 2011 to early 2012.

Physicians received three to four reminders to complete the survey and were offered $35 to $45 incentive checks to respond. A total of 1,820 completed the survey (60%) — 62% were primary care physicians (PCPs) and 56% were specialists. PCPs were more likely to work in smaller practices (39%) and to be part of a physician organization or network (67.4%) than specialists.

Meaningful use was defined as meeting 11 of the 15 stage one core requirements. Only 9.8% met these criteria, the researchers found.

The most common reported EHR uses were viewing lab results, writing prescriptions, viewing radiology or imaging results and recording clinical notes. Least common  uses included sharing patient clinical notes and lab and diagnostic test results externally, generating quality metrics and sending patients post-visit notes and copies of their health records.

Ease of use of these systems was varied. A system rating of “easy” was significantly more likely by physicians with an EHR that met meaningful use criteria compared to ratings by physicians with an EHR not meeting the standard.

Since 2011, Medicare and Medicaid made meaningful use payments to more than 145,000 healthcare providers (20% of those eligible), accounting for more than $3.9 billion in September 2012.

Differences in early EHR adopters vs. later EHR adopters in personal and practice characteristics may make later adopters more difficult to reach to ensure they are meeting meaningful use standards, the researchers noted.

“Given that many physicians have at least some functions in place, one promising strategy may be to focus on the distribution of adoption of individual meaningful use functions,” they wrote.

Study limitations included the potential for response bias, inability to verify EHR use accuracy, and the fact that the study’s definition of meaningful use did not include all criteria for stage one guidelines.


  1. DesRoches C et al. Ann Intern Med. 2013; 158(11):791-799.