Meaningful Use Attestation Report
Updated February 19, 2013 - Since health providers are now reporting meaningful use data to the Centers for Medicare and Medicaid Services (CMS) as criteria for reimbursement under their EHR Incentive Programs, we now have access to a host of EHR usage data that was previously unavailable.
We decided to use this dataset to drill into attestations in one specific field--psychiatry--to get a handle on which EHR vendors are leading in that area. Although attestations and market share are not the same thing, we believe they are closely correlated. And if a practice is reporting data to CMS then presumably their EHR is doing its job. Therefore, we believe this is a valuable assessment to make for medical providers looking to make an EHR purchase decision.
Market Share Analysis
Out of 74 different vendors attesting meaningful use for the psychiatry field, the number one provider, Epic Systems Corporation, holds over a third of the market (34.4%). This is a significant lead over the second place contender, PracticeFusion (9.8%), and as many as the second through ninth place vendors combined, a list that includes EHR giants Allscripts and eClinicalWorks.
|Vendor||Attestations||Percent of Attestations|
|Epic Systems Corporation||329||34.4%|
|Valant Medical Solutions, Inc.||25||2.6%|
Although Epic is clearly the market leader, the rest of the market is very disparate—three-quarters of vendors share 16% of the market.
|Vendor||Attestations||Percent of Attestations|
|Epic (34% market share)||329||34.4%|
|Vendors 2-7 (2%-10% market share each)||294||30.7%|
|Vendors 8-20 (1%-1.99% market share each)||178||18.6%|
|Vendors 21-75 (<1% market share each)||156||16.3%|
The great majority of respondents (85.9%) reported using complete EHRs, with only 14.1% reporting modular EHR use (i.e., using some EHR component like e-Prescribing, but not a complete EHR).
Of the 121,441 attestations for meaningful use in the original data, 957 were used to compile this report. Over 98% of those (944) were from Psychiatry, with the remainder coming from Addiction Medicine (6) and Geriatric Psychiatry (7). The culled down data is available here.
Note that because psychologists, therapists and certain other behavioral health specialists don’t qualify for reimbursements under the EHR Incentive Programs, none of those are included in this analysis.
Electronic medical record (EMR) / electronic health record (EHR) systems for mental and behavioral health providers have unique features and capabilities specifically for counselors, mental health clinics, and group practices. For example, leading systems offer charting templates for evaluation and progress notes, automated coding to ensure highest possible E/M codes and medication and prescription management tools. Additionally, software for psychiatrists, psychologists, and behavioral centers often have e-prescribing to electronically generate prescriptions and the proper documentation, and a laboratory request interface to track patient lab results.
When selecting a mental or behavioral health EMR, providers should consider other features necessary to improve efficiency and care at their agency or facility. For example, some psychiatry electronic medical records allow you to create and store custom, reusable notes in a database for quick retrieval during a patient encounter. Others will need administrative features like a calendar application or patient scheduling system for clinical appointments.
Here are some of the capabilities to consider:
|Workflow management||Make sure your system facilitates point of care and supports, rather than interferes, with your opportunities for direct patient interaction, thus supporting the way you do business.|
|Advanced note management||Mental and behavioral health specialists may need to access their old notes quickly to review previous sessions. Behavioral health electronic health records software should allow for easy retrieval and viewing of the notes and assessment in multi-axial format.|
|Specialty EMR templates||Specialty psychiatric SOAP notes templates include anxiety, depression, delirium, mania, psychosis, eating disorders, addiction, personality disorders, suicide, and more. Providers can use the pre-existing templates or, if desired, customize them even further.|
|GAF charts||Monitor the severity of mental or behavioral factors with a graphical depiction of ongoing progress, rating the social, occupational, and psychological functioning of a patient through Global Assessment of Functioning (GAF).|
|Specialty ICD-9 billing & coding||Many mental and behavioral health specialists have needs unique to their practice, depending on their area of focus. A strong solution will provide detailed billing support without the clutter of additional codes you don’t need.|
Market Trends You Should Understand
There are several trends happening in electronic medical records for mental health and psychiatry software. Here are a few you should consider as you select a product and vendor:
- ONC-ATCB Certification. Perhaps the most significant trend in psychiatric software and mental health systems is the US government-backed move towards electronic medical records (EMR) adoption. A major component of the American Recovery and Reinvestment Act (signed into law by President Obama in 2009) is the Health Information Technology for Economic and Clinical Health (HITECH) Act, which offers a “carrots and sticks” plan for medical offices to adopt mental health electronic health records. Qualified practices can earn up to $44,000 in reimbursements in the form of increased Medicare and Medicaid premiums. To qualify, mental and behavioral health professionals have to show “meaningful use” of ONC-ATCB-certified mental health EHR software.
Guidelines for Stage 2 of HITECH were announced in early 2012, and physicians have a mandate to become meaningful users by 2015. Those that fail to qualify will face decreased Medicare and Medicaid payments. For those evaluating mental health software, one major deciding factor should be whether it’s certified or not.
- Mobile device support. The number of doctors and medical professionals bringing their mobile devices to work and accessing data on the go--via smartphones, tablets, etc--is growing. Psychology practice management software and psychiatry EMR software vendors are responding by offering more support for wireless devices. Some are even offering native apps for various operating systems (Apple, Android, Windows). When evaluating mental and behavioral health EHR software, consider what you’ll need in terms of mobile support.
- Software as a Service (SaaS). The number of buyers interested only in web-based EMR mental health systems is climbing at a steady rate. As cloud computing catches on in other industries, it is emerging quickly in health care as well. Common reasons for behavioral health software adoption include remote access, lower upfront costs, and reduced IT burden. Also, developments in HIPAA compliance, data security and encryption, server reliability, and data backup make web-based behavioral health electronic health records viable alternatives for mental health practices.