142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Factors Related to Meaningful Use Achievement among NYC Healthcare Providers

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Jason Wang, PhD , Primary Care Information Project, NYC Department of Health and Mental Hygiene, Long Island City, NY
Jisung Cha, PhD , Primary Care Information Project, NYC DOHMH, Queens, NY
Brent Stackhouse, MBA , PCIP, NYC DOHMH
Sarah Shih, MPH , Primary Care Information Project, New York City Department of Health and Mental Hygiene, New York, NY
Background:Healthcare providers adopting electronic health records (EHR) across the nation have pursued meaningful use (MU) objectives as a means of demonstrating their ability to deliver higher quality care.

Objective/Purpose: Exploring the relationship between provider characteristics and MU Stage 1 achievement among primary care providers.

Methods: Small practice provider level data obtained from the New York City regional extension center (REC) were used for logistic regression analysis. Outcome variable was achievement of MU Stage 1 Milestone 3 (M3). Independent variables included patient-centered medical home (PCMH) recognition, length of time using an EHR, practice size, proportion of patients on Medicaid, selection of incentive programs, and provider specialty.

Results: By January 2014, 2984 small practice providers had achieved MU Stage 1 Milestone 1 (M1) and selected a CMS incentive program (62.0% Medicaid and 38.0% Medicare). 66.0% achieved M3 with average 18.7 months from M1 to M3; 83.2% were primary care providers and 16.8% were specialists; 56.2% were with practices that had less than 11 providers; 27.6% achieved PCMH recognition; average months of using EHR was 58.1; average percent of Medicaid patients was 37.0%.

Statistically significant factors related to achieving M3 include: having PCMH recognition (OR =1.97; CI=1.57, 2.46), months using EHR (OR=1.005; CI=1.001, 1.008), practice size less than 11 providers (OR=1.49; CI=1.21, 1.83), identified specialty as primary care (OR=20.42; CI=14.78, 28.24), selecting the Medicaid incentive program (OR=0.53; CI=0.41, 0.68), and percent of Medicaid patients seen in the practice (OR=0.993; CI=0.989, 0.998).

Discussion/conclusions:Among small practice providers, positive factors related to achieving M3 include PCMH recognition, length of EHR usage, and being a primary care provider. Providers selecting the Medicaid incentive program and serving a higher proportion of Medicaid patients were less likely to achieve M3. Policy makers may need to allow for longer program periods or provide additional assistance to facilitate practices serving vulnerable populations.

Learning Areas:

Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the key meaningful use stage 1 objectives that may facilitate better health care Discuss the challenges some primary care providers face in adopting an EHR Analyze the factors related to the provider achievement of meaningful use stage 1

Keyword(s): Public Health Research, Patient-Centered Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Senior Director of Evaluation and Analysis at NYC Dept of Health and Mental Hygiene, I have been working in healthcare research for nearly 20 years with numerous publications on health disparity and the use of electronic record systems.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.