About 30 years ago, when cable television hit its stride, pundits watching the industry assumed that home adoption would quickly climb to near 100 percent. Instead, for a variety of reasons, consumer adoption more or less froze at the 50 percent mark for many years.
Maybe the industry didn’t their pricing strategy right; maybe consumers were perfectly happy with broadcast television; or maybe the existing broadcast networks greased a few palms and helped regulators slow down its growth in subtle ways.
In any event, the cable industry has improved its performance enormously; in fact, it hit 70% in the late 90s, though that number has fallen significantly as satellite providers have horned in.
So, why bring up cable TV in a forum aimed at dissecting the EMR business? Because I think the cable industry’s experience is instructive in how we think about EMR adoption.
First, some data points. According to study released in January by the CDC’s National Center for Health Statistics, 50.7 percent of physicians were using EMRs in their offices in 2010. That’s a dramatic upswing from previous years, the agency noted.
Of course, practices are eager to collect Meaningful Use incentives if they can. Also, as older physicians retire, younger, more-wired MDs are taking up the EMR banner. (In fact, CDC data concludes that the younger a physician is, the more likely they were to adopt EMR technology.)
Not only that, hospitals are helping to grease the skids, with one-third offering to subsidize EMR buys and 60 percent offering doctors access to the facility’s EMR, the CDC found.
All of that sounds great, particularly if you’re an EMR vendor. But I think it’s a bit early, as it was for cable pundits, to predict that EMR adoption is at some kind of tipping point. Whiz-bang technology always looks great from the peanut gallery — especially to analysts and editors — but it often looks different on the ground.
Not only do I think exponential growth is unlikely, I’d argue that adoption by physicians will be painfully slow for at least a few years more, gaining say, 5 to 7 percentage points a year at best.
Why do I feel that way? Here’s a few reasons:
* Few (if any) vendors can honestly say that introducing their product won’t bog down a practice and trash its productivity for months at least. Doctors know this.
* Smaller practices don’t, and aren’t likely to, have full-time IT staffers. Even practices that want to adopt don’t have the reassurance of a dedicated IT brain that knows their needs. Under these circumstances, buying an EMR is a scary investment.
* Other trends that might spark EMR adoption — such as the emergence of RHIOs/HIEs — are moving at a snail’s pace. If a doctor doesn’t have the added incentive of sharing patient data to spark adoption, that’s one more reason to delay.
Look, maybe I’m being pessimistic, or short-sighted. But I simply don’t think the EMR vendor market nor the physician buyer side have gelled enough to spark a revolution. I guess we’ll just have to wait and see.