Capital Region Doctors’ Meaningful Use of Electronic Health Records Bodes Well for Population Health Technology Cluster
The Capital Region’s primary care providers who received federal assistance to adopt electronic health records (EHRs) are among the state’s strongest users of the technology, according to a Center for Economic Growth (CEG) analysis of data from the Office of the National Coordinator for Health Information Technology (ONC Health IT).
According to ONC Health IT’s latest report on performance indicators for its Regional Extension Centers (REC) program, 93.2 percent of the 412 primary care providers in the eight-county Capital Region who received REC assistance and went live with EHRs had been using the technology meaningfully by mid-2015. That was the third highest rate of New York’s 10 regions and well above the statewide rate of 75.2 percent. This represents a positive advancement for the development of a robust “population health technology cluster,” as envisioned by the “Next-Tech” strategy of Capital 20.20, the region’s five-year economic development plan.
According to a recent KPMG survey, 38 percent of College of Healthcare Information Management Executives (CHIME) members identified electronic medical record (EMR) optimization as their primary capital investment priority for the next three years. Population health innovation will be the subject of a summit sponsored by IgniteU on March 27 in Albany.
REC Program
The ONC Health IT, which is responsible for the development of a secure, interoperable health information system, used funding from the American Recovery and Reinvestment Act to establish nationwide RECs tasked with helping providers adopt and meaningfully use EHRs.
New York’s REC was the New York eHealth Collaborative, now known as Healthcare Advisory Professional Services. It supports the exchange of EHRs and consists of eight qualified entities (QEs). The QE that covers the Capital Region is Hixny. Not all providers participated in the REC program. By June 2015, approximately 49 percent of New York’s primary care providers and 34 percent in the Capital Region had gone live with an EHR system under the REC program.[1]
Medicare EHR Incentive Program
A CEG analysis of data from a separate survey of participants in ONC Health IT’s Medicare EHR 
Incentive Program found that 699, or 75.5 percent, of respondent providers in the Capital Region in 2015 attested to being at the most advanced stage of meaningful EHR use, which was stage 2. Providers at this stage attested to using health IT “for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.” The first year in which providers could attest to being at stage 2 was 2014. Before advancing to stage 2, providers must attest to at least two years of the first stage of meaningful use.
Nine out of the 10 Capital Region hospitals that participated in the Medicare EHR Incentive Program survey attested to being at the second stage of EHR meaningful use. Burdett Care Center in Troy was the only area facility attesting to being at stage 1 and data was not available for Ellis Hospital in Schenectady.
Practice-Based Population Health
The Capital Region’s EHR meaningful use rate among primary care physicians is important because, as a study recently published in the Journal of Medical Informatics noted, “EHR usage is pivotal in setting the foundation to support [practice-based population health] PBPH.” PBPH management is “an approach to care that uses information on a group (population) of patients within a primary care practice or group of practices (practice based) to improve the care and clinical outcomes of patients within that practice,” said the study’s authors from SUNY Binghamton and several Montreal institutions. They found that EHR-enabled clinics completed a full review of charts in an average 1.37 hours, compared to an average 10 percent review of charts in 3.9 hours by paper-based clinics. There was also a major gap in preparedness between the EHR- and paper-based clinics.
Under Capital 20.20, the Capital Region’s population health technology cluster would unite providers, payors, technology companies, community organizations and government programs to develop high-tech, data-driven models that improve patient care and reduce costs through the development and use of technology. Key elements of this initiative include patient data in EHRs from hospitals, physician networks, community-based organizations and insurers. This data would be centrally and securely located in a health data warehouse. Analytical tools, such as the cognitive computing that IBM Watson Health provides to Albany Medical Center, would mine the data to facilitate user decision making.
Adding to this dynamic would be wearable health monitoring technologies made by Capital Region technology companies. GE Global Research in Niskayuna, for example, recently unveiled butterfly wing-inspired gas sensors that could supplant classical and micro-fabricated instruments based on gas chromatography and mass spectrometry. The sensors, if transferred from the lab to the field, could be used in wearable devices for monitoring medical patients and the chronically ill. Several researchers at the SUNY Polytechnic Institute are also working on wearable sensor-related projects.
In addition to improving the health care provided to people in the Capital Region, the spread of EHR usage is also boosting its economy. In 2015 the Albany-Schenectady-Troy metropolitan statistical area had 590 medical records and health information technicians, up 18 percent from five years earlier, according to U.S. Bureau of Labor Statistics data.
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For more information, contact CEG Director of Research and Communications James Schlett at jamess@ceg.org. Don’t miss these insights into the trends that are shaping the Capital Region’s economy. Sign up for CEG’s e-news.
[1] Based on 2015 REC performance indicators and 2013 office-based provider counts.
