Pilot study of meaningful use of electronic health records in radiation oncology

Abstract

Purpose: Adoption and meaningful use of electronic health record (EHR) systems is an important national goal. We undertook a pilot study to determine the level of adoption and barriers to implementation of meaningful use (MU) of EHR systems as defined by the Centers for Medicare & Medicaid Services (CMS) in US radiation oncology practices.

Materials and methods: We administered a Web-based survey instrument to a convenience sample of 40 departments of radiation oncology. We determined the current status of EHR system use at each facility, attitudes toward EHR systems, knowledge of MU criteria, plans and barriers to implementation, and whether selected interventions would be helpful with regard to compliance with MU criteria.

Results: Twenty-one of 40 radiation oncology facilities completed the survey, for a 53% response rate. Respondents were mostly large academic practices with a median of six (range, one to 32) full-time physicians and 70 (range, eight to 650) patients treated daily. Most facilities (81%) currently used an EHR system. The majority (84%) of facilities were aware of MU criteria, and of these, 67% expected to implement MU-compliant systems by the year 1 reporting deadline of October 1, 2011. The most frequently cited barriers to implementation were high cost, difficulty integrating with hospital systems, and a lack of national guidelines for implementation.

Conclusion: Most large academic radiation oncology practices have already incorporated EHR systems into practice and plan to meet MU requirements. Further work should focus on assessment of needs for smaller practices. Radiation oncology-specific guidelines may improve widespread adoption.

Figure 1.

Most important barriers to implementation of meaningful use–compliant electronic health record (EHR) systems. Responses are based on 18 respondents with knowledge of meaningful use criteria.

Figure A1.

Perception of effect of electronic health record (EHR) systems on quality and safety. (A) No. of respondents to the question of whether EHR improved safety or quality of 17 facilities with EHR systems. (B) Ways in which EHR improved safety or quality among 17 facilities with EHR. Responses include both facilities which felt that EHR improved quality (n = 12) and safety and those that were not sure (n = 5).

Figure A2.

Reasons for implementing meaningful use–compliant electronic health record (EHR) systems. Responses are based on 18 respondents with knowledge of meaningful use criteria. Respondents were allowed to select multiple reasons.

Figure A3.

Most useful measures to help implementation of meaningful use–compliant electronic health record systems. Responses are based on 18 respondents with knowledge of meaningful use criteria. Rad Onc, radiation oncology; ASTRO, American Society for Radiation Oncology.