title: Associations Between Practice Characteristics and Demonstration of Stage 1 Meaningful Use for the Electronic Health Record Incentive Program.
abstract: BACKGROUND
  The Medicare and Medicaid meaningful use (MU) incentive programs promote adoption and "meaningful use" of certified electronic health records among hospitals and eligible providers in outpatient settings, with a goal of improving the quality of patient care. Despite the potential importance of MU for providers and patients, little is currently known about the practice characteristics that facilitate providers' demonstration of MU. This study examined whether selected practice characteristics were associated with providers' meeting Stage 1 MU objectives at the end of 1 year in a single large North Carolina integrated delivery system.
  
  
  METHODS
  Our retrospective database analysis included all 702 eligible providers from 54 ambulatory care practices on the main campus of the University of North Carolina Health Care System. We assessed associations between providers' ability to meet Stage 1 MU objectives as of December 2012 and the following practice characteristics: practice specialty, size, and mix of Medicare- and Medicaid-eligible providers.
  
  
  RESULTS
  The following practice characteristics were associated with providers' ability to meet MU objectives: primary care practices as compared to specialty practices (odds ratio [OR] = 2.49; 95% CI, 1.11-5.62), small practices as compared to medium-sized practices (OR = 0.29; 95% CI, 0.09-0.89), and the presence of only Medicare-eligible providers in the practice as compared to the presence of only Medicaid-eligible providers (OR = 6.48; 95% Cl, 1.08-38.97).
  
  
  CONCLUSIONS
  Because our sample was drawn from a single integrated delivery system, results may not be generalizable to all ambulatory practice settings.
  
  
  CONCLUSIONS
  This study suggests that larger practices, primary care practices, and practices comprised of Medicare-eligible providers may be better able to meet MU objectives. Further research is needed to evaluate strategies that account for practice characteristics and other contextual factors in the MU implementation process.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Shea
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Reiter
authors.forename: Mark A
authors.initials: MA
authors.lastname: Weaver
authors.forename: Jonathan
authors.initials: J
authors.lastname: Thornhill
authors.forename: Robb
authors.initials: R
authors.lastname: Malone
mesh_terms: D000553:Ambulatory Care / Q000592:standards*; D057286:Electronic Health Records / Q000191:economics; D006801:Humans; D062527:Meaningful Use; D008484:Medicaid; D006278:Medicare; D009657:North Carolina; D011320:Primary Health Care / Q000592:standards*; D012189:Retrospective Studies; D013038:Specialization / Q000592:standards; D014481:United States