Meaningful use, improved patient care and competition among providers are a few of the reasons electronic health records are succeeding at hospitals, according to one expert.

David Lewis, principal at CSC Consulting, shared with Healthcare IT News his top 10 list of why EHRs are gaining more positive traction, based on what he's seeing from his hospital clients.

In November, Healthcare IT News also interviewed Karen Fuller, a principal with CSC's Health Delivery Group, who weighed in on her top 10 list of why EHRs are succeeding today. The difference between the two lists is that Fuller focused on internal factors that had an impact on EHR implementation, such as leadership and governance, whereas Lewis's list focuses on external factors, such as the government's meaningful use incentives.   

Top 10 external reasons EHRs are succeeding:

1. Meaningful use (MU) incentives – and future reimbursement penalties for not meeting those guidelines – are creating additional reasons to implement EHRs. "The Medicaid incentives are what people are worried about right now over Medicare," said Lewis. He said there are tools out there that will help "organizations to run numbers against MU requirements and penalties to see the exact impact," it might have. "Hospitals operate on pencil-thin margins right now. That's why any cuts in Medicare or Medicaid are just note feasible right now," he added.

2. MU, as defined for the EHR incentive program, eliminates ambiguity about what comprises an inpatient EHR, and provides guidance for implementation. Lewis said that although the final rule has been published, there still exists some "leeway" that will result in hospitals having to make decisions. For example, he said they might have to ask themselves whether they're going to do just enough to meet the MU requirements or will they go above and beyond. "There are nuances within the rule that I think each hospital will have to examine for themselves," said Lewis.

3. Partly because of the above, vendor products are getting better – finally incorporating all required functionality, with improved ease of use. Lewis noted that there is a distinction between meeting MU requirements and having a vendor product that is certified to meet the requirements. The certification just means that the technology has "the functionality and ability to capture data elements needed for MU," he said.

4. Organizations are embracing the need to implement this technology and are committing resources to it. Even though "money is still tight" at most of the organizations Lewis talks to, he says that committing resources to EHRs is a top priority.

5. Costs have always been a major barrier, and although the financial incentives of MU are tied to achievement rather than intentions, they are generous enough to cover part of the cost involved in implementing EHRs. Depending on the organization, the incentives will cover part an EHR and make it easier for the hospital to at least budget for it, said Lewis.

List is continued on the next page.