Improvingestimates for electronic health record take up in Ohio: A small area estimation technique

Much effort health policy research has gone into the examination of strategies to increase health provider quality, efficiency, and patient outcomes. The American Recovery and Reinvestment Act (ARRA) and the Patient Protection and Affordable Care Act (PPACA) position the adoption of EHR as a mechanism of medical costs control and quality improvement meant to compliment the national expansion of health care (Steinbrook, 2009). It is within these policy developments and the desire to improve quality, efficiency, and outcomes that Ohio Medicaid is pursuing the examination of Ohio-based EHR adoption and expansion. As an enticement for greater degrees of EHR adoption, Ohio is implementing the Medicaid Provider Incentive Program (MPIP) to assist practices having financial difficulties or have hesitations in adopting EHR. To determine Ohio's EHR uptake, the Ohio Department of Job and Family Services and The Ohio Colleges of Medicine, Government Resource Center administered the Electronic Health Records Survey. The goal of this paper is to accurately estimate the Electronic Health Record (EHR) uptake rates for Ohio medical practitioners, primary care physicians, medical specialists, dentists, nurse practitioners, and nurse midwives, with a Medicaid patient volume above 30%, and pediatricians with a Medicaid patient volume above 20%. Two estimation techniques were performed to estimate Ohio's EHR uptake, (1) a Weighted Stratified Sampling Estimator and (2) a Small Area Estimation Estimator. The results of these two estimators will be compared to determine the number of practitioners in Ohio eligible for the MPIP