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Slide Presentation of the 2007 Annual Meeting of AHRQ

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The Big Picture is As Murky As It Ever Was...

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  • The message on quality and measurement is starting to sink in, but there is no sense of urgency
    • Large groups and hospital-employed moving faster, but small practice penetration is lethargic
    • Small practices don't see this as a "competitive advantage"
  • Current reimbursement model doesn't provide enough focused incentives to accelerate adoption, largely because of upfront capital and technical capacity hurdles
    • Supply- and demand-side too fragmented
    • P4P without EHRs too shallow to make a difference
  • Even if adoption increased on its own, the market won't implement these systems to deliver value
    • Bad systems and/or bad implementations offer little, if any, value
    • Failure in retail market is on the order of 30%
    • EHRs don't spontaneously generate meaningful clinical data—required behavior and process changes are rarely implemented by practices on their own
    • Physicians don't capture (or understand) the full benefit of connectivity, so they won't invest in it on their own
    • Not clear how to develop interoperable network in laissez-faire model—medical trading areas not formally organized in a way that facilitates definition of local network business

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