Priority primary care practices with low resources—practices not associated with larger systems—lack access to the necessary technical expertise, financial resources, and leverage with vendors for sustaining meaningful use of electronic health records beyond implementation. And, rural priority practices are particularly at a disadvantage.

That is the conclusion of a new study in the Annals of Family Medicine. The study, written by researchers at the University of Alberta, State University of New York at Albany, and the Ann Arbor, Mich.-based research organization Altarum Institute, explores potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers and priority practices in Michigan.

"Our findings suggest that, without ongoing support addressing the themes identified above, low-resource practices may achieve Stage 1 meaningful use only to fall by the wayside, resulting in an ever-widening ‘digital divide’ as better-resourced practices continue to increase the sophistication of their health IT operations," the authors warn. "The advances in clinical processes expected for Stage 2 and Stage 3 meaningful use will strain both the technological expertise and management expertise of low-resource practices."

Ultimately, they conclude, any long-term stable solutions must address the operational and financial needs of low-resource primary care practices in general, and the additional needs of rural practices in particular.

“Absent that, the multifaceted challenge of health IT maintenance will almost inevitably overwhelm low-resource practices,” according to researchers. “The operational and financial consequences of falling behind in maintenance will mean lower quality care for the patients in areas these practices serve—or quite possibly no care at all.”

The full study is available here.

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