Researchers examined the relationship between practices who employ advanced practice providers and their EHR adoption habits.
Three-forths of practices that employ advanced practice providers (APPs) — such as nurse practitioners (NPs) and physician assistants (PAs) — have adopted EHR technology, according to a recent study published in the American Journal of Managed Care.
The study sought to examine the relationship between practices who employ APPs and EHR adoption habits, taking note of the role both elements play in supporting the triple aim of better health care, better costs, and healthier people.
The researchers hypothesized that practices that employ NPs, PAs, and the like are also more likely to adopt EHR technology because APPs promote a high level of team-based care and care coordination, two elements which are enhanced by EHR technology.
"In team-based approaches, APPs can provide care for the more routine cases, freeing up physicians to care for patients with more complex health problems,” the researchers explained. “Knowing that practices that employ APPs are prepared to implement team-based approaches to care, which could be further enhanced through the use of health IT, it is important to more fully examine the association between health IT adoption and the presence of APPs in a practice.”
Using results of a large-scale national survey from 2013, the researchers concluded that those practices that employ APPs are indeed more likely to adopt EHR technology than those that do not. Nearly 74 percent of practices that employ NPs adopt EHRs, while 76 percent of practices with PAs adopt EHRs. In contrast, only 58 percent of practices that do not employ APPs adopt EHRs.
The researchers also explained that those practices that employ APPs see greater clinical efficiency. Because physicians see more tasks associated with EHR integrating EHRs into care, it is possible that practices employ more APPs to do the simpler patient care so that physicians can concentrate on more complex cases:
The study also examined the various EHR capabilities that different practices adopt. Of the hospitals that adopted an EHR in 2013, 80 percent of them had an EHR that managed patient notes, 77 percent had one that managed electronic prescriptions, and and 76 percent had one that allowed the user to view patient lab results and x-rays.
These varying capabilities showed that practices that adopted EHRs were increasing their integrated and team-based care initiatives.
Additionally, the researchers broke down which kinds of hospitals employ APPs. Overall, primary care practices were twice as likely to employ APPs as multi-specialty practices. Additionally, rural hospitals were more likely to employ APPs than urban practices. Large practices were also more likely to employ APPs than smaller ones.
Although the researchers reported they were fairly confident in their findings that practices that employ APPs are more likely to adopt EHRs, they were not certain of the causality. However, they did present one potential explanation, stating that practices may have underlying qualities that make them more apt to adopt both EHRs and employ APPs.
“Prior work has shown that practices that adopted EHRs were more likely to have innovative physicians on staff. The associations identified here may be a result of having innovative physicians on staff, and those physicians promoting team-based care, as well as EHR adoption,” the researchers concluded. “These results do demonstrate that practices with APPs on staff have higher rates of health IT adoption and use, and thus, are primed to take the next steps to delivery system reform.”