The American Academy of Family Physicians' (AAFP) Center for Health Information Technology (CHiT) announced today the results of the Electronic Health Record (EHR) Pilot Project, designed to study the barriers and keys to successful EHR implementation in small physician practices. The key finding was the practices' acceptance of and success with the Application Service Provider (ASP) or remotely hosted model EHR. The ASP model requires fewer hardware components and is easier to maintain and upgrade compared with traditional client-server software applications.
Additionally, the project showed that the challenges of training, implementation, and ongoing support for small physician practices -- typically faced with tight budgets -- can be significantly reduced by using a combination of Web conferences, email discussion lists and telephone meetings to replace expensive on-site visits by vendors or trainers. Current data indicates that rates of adoption in small practices continue to lag, in part because of potential high costs and loss of productivity from EHR implementation. No on-site visits for training or implementation were conducted during the EHR Pilot Project.
"This was a true collaborative effort," said David C. Kibbe, M.D., director of the AAFP's Center for Health Information Technology. "It points us in the direction of Internet-based applications that will support the IT needs of small medical practices, and helps us understand in detail some of the necessary factors to success with EHR adoption in small family practices. We can definitely build on this project."
The EHR Pilot Project was designed to include six typical small family practices that vary from one to five physicians, in six different U.S. locations. Additionally, practices were selected on the basis of their average familiarity with computers: 'technical enthusiasts' were specifically excluded from the candidate pool.
The physicians and staff from the six practices participating in the Pilot Project committed to three main objectives:
EHR Pilot Project Shows ASP Model Has Benefits for Small Physician Practices
- implement and use an ASP, Internet-based, EHR system over a six-month period;
- intensively study the barriers and keys to success during implementation; and
- identify the special needs of small and solo practices and find ways to address those needs before and after implementation.
"The ASP model worked well," said Ken Bertka, M.D., a family physician from West Toledo Family Physicians and a participant in the project. "Despite a direct lightning hit and a major flood in our office, our EHR was down for less than two hours total in a six-month period. That level of reliability exceeds what most large health systems experience."
All phases of the project were carried out as a collaborative between the practices, staff from the AAFP's CHiT, and personnel from MedPlexus Inc., Siemens Medical Solutions, Hewlett Packard and Phyxe, Inc.
All phases of the project were carried out as a collaborative between the practices, staff from the AAFP's CHiT, and personnel from MedPlexus Inc., Siemens Medical Solutions, Hewlett Packard and Phyxe, Inc.