Many smaller private practices have been hesitant so far to adopt EHRs because of their perceived complex nature. A logical first step toward EHR adoption by a smaller provider might be the utilization of an e-prescription program.

“The biggest hurdle (for small practices) is probably really feeling like it’s something they can’t do,” said Cam Deemer, president of DrFirst, in a recent interview at HiMSS12 for HealthcareIT News. “There’s a mystery about it. There’s kind of a feeling that ‘this may work for other practices, but I don’t know how I can adapt to it.’”

David Stinner, president of the EHR vendor US itek group, echoes this sentiment that smaller providers are sitting on the sidelines. He said switching to computerized records could be a generational issue, with some doctors not looking to change habits.

“Doctors don’t like to have to make that decision. They say ‘I’m too old, I’m retiring in 15 years’– well you still got 15 years and you’ll probably practice for 25. So the fact that the government mandated (EHRs) is a good thing,” said Stinner.

Some are of these doctors’ hesitations and concerns are well founded. A February 2012 HIMSS survey of health IT professionals found such a large demand and strain on the health IT industry, that almost two-thirds of respondents are planning on hiring more staff in the next year.

Large hospitals and providers have the luxury of either adding to their IT staff or outsourcing to a healthcare IT company able to handle the growing challenges and demands. Smaller providers that don’t have this luxury are in danger of being left behind.

A study by Cal eConnect on e-prescribing in California reinforces the notion that there is a legitimate gap between large and small providers. The study found that there are many barriers to the adoption of an e-prescribing program including workflow issues, conservatism by some doctors, and some, mostly rural, pharmacies that were unable to accept electronic prescriptions.

For doctors looking to take that first step toward adopting an EHR, an e-prescription program might be a logical first step. The Centers for Medicare and Medicaid Services (CMS) defines e-prescribing as “a prescriber’s ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care.”

The CMS website also says that e-prescribing reduces errors and improves overall quality of patient care.

There are many other benefits that can be had from adopting an e-prescription program. According to a study published in the January 2012 issue of Academic Emergency Medicine, e-prescription programs “significantly minimized pharmacy wait time and improved patient satisfaction at the pharmacy.”
The study, which surveyed 454 patients, and said that e-prescribing reduced pharmacy wait time from 15 to 0 minutes and improved patient satisfaction at the pharmacy.

However, the biggest reasons for providers to adopt an e-prescription program are the financial incentives and penalties involved. Starting in 2012, providers could be either receive bonus payments or suffer financial penalties as a percentage of their total Medicare Part B Fee-For-Service Allowed Charges. Those providers who meet CMS standards are eligible for a 1 percent bonus on their 2012 Medicare revenue. Alternately, providers who do not meet the CMS standards will suffer a 1 percent penalty on their 2012 Medicare revenue.