The study also finds that 56 percent of providers report no change in optimism or less optimism this year about America's EHR transition prognosis. Moving beyond assessing symptoms to analyze causes, 75 percent of providers flag IT implementation costs as the number-one obstacle to wide-scale EHR deployment, and 67 percent assert that direct government funding would accelerate the realization of HHS' EHR initiatives. Forty-four percent also cite IT infrastructure challenges - calling out the need for standards and system interoperability - as major obstacles to EHR implementation.

In 2004, President George W. Bush called for widespread adoption of EHRs by the year 2014. The Nationwide Health Information Network (NHIN) - the result of HHS' recent efforts to create a series of prototypes for an internet-based architecture that links disparate healthcare information systems together to allow healthcare providers across the country to securely share clinical information - is an important first step toward achieving this national goal. Provider participation in regional networks for clinician interconnection, known as Regional Health Information Organizations (RHIO), also supports the administration's EHR objectives.

"The provider community recognizes that through embracing the potential of EHRs there is significant opportunity to improve quality of care and patient outcomes, as well as to reduce costs," said Oracle Vice President for Global Health Industries Mychelle Mowry. "However, the precise range of EHR implementation and associated funding sources are still in question. Oracle's goal is to enable healthcare IT systems - and, by extension, healthcare providers - to communicate precisely and unambiguously with one another, sharing data that is complete, accurate and comparable. Our nation's health depends upon it."

Providers Take Modernization Medicine Seventy-seven percent of providers assert they plan to implement EHRs, and 85 percent of this majority estimate completion within five years. Clinics/community health organizations lead the charge to EHR implementation - 92 percent plan to implement EHRs, and 46 percent indicate they will complete implementation in less than one year - followed by physician practice groups and hospitals/healthcare systems - 86 percent of both groups indicate plans to implement EHRs. While 50 percent of physician practice groups plan to complete their implementations in less than one year, hospitals/healthcare systems project longer implementation timelines.

Further, the provider community largely embraces RHIO initiatives, with 42 percent of respondents currently participating in or planning to participate in RHIO projects. Clinics/community health organizations once again lead their counterparts in current involvement in or plans for participation in a RHIO, followed by managed care organizations and independent delivery networks. Clinics also have the most aggressive timeline for RHIO participation, with 33 percent indicating either current involvement in a RHIO or plans to be active in a RHIO within one year and 44 percent anticipating completion within five years.

Providers Assert Confidence in HHS EHR Timeline
Fifty-six percent of respondents assert confidence that HHS will achieve its NHIN EHR goals by 2014. In addition, 58 percent of providers are more optimistic this year than last about their own organization's ability to achieve its EHR goals. Of note, some 38 percent of respondents that question HHS' ability to meet EHR goals assert that 20 years is a more realistic timeline than 10 years for national compliance.

Providers Struggle with Technical and Financial Afflictions
Seventy-five percent of providers flag technology/implementation costs as the number-one challenge to successful EHR roll out, and 44 percent cite IT infrastructure challenges. Specifically, respondents singled out the requirement for IT standards and healthcare system interoperability. Other areas of concern include security/privacy and change management as issues causing major obstacles in EHR deployment plans.

"The medical profession should be built on standards," continued Mowry. "How can a pharmacist fill a prescription accurately without a common frame of reference among healthcare professionals? The international standards organization Health Level 7 (HL-7) offers a path forward on IT standardization to support EHR implementation. We need to move quickly to allow all healthcare organizations to read from the same unambiguous chart."

Indicating that incentives would further aid the realization of HHS' goal, providers assert direct government funding (67 percent), industry technology donations (58 percent) and tax incentive programs (52 percent) would accelerate NHIN roll out and their individual EHR implementations.

Methodology
The Oracle Healthcare Provider Examination study results are based on an online survey of healthcare providers nationwide. The sample size (364 respondents) spans the healthcare industry continuum, with representative organizational types including hospitals/healthcare systems, managed care facilities, independent delivery networks, public health organizations, clinics/community centers and physician group practices. Further, respondents indicate professional titles ranging from C-level executive management to clinician, from IT/network management to department-level management. The study has a 95 percent confidence level with a +/-5.05 percent margin of error. To download the full findings of the Oracle Healthcare Provider Examination study, please visit www.oracle.com/start, and enter keyword EHRSurvey.

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• Oracle Healthcare's Profile

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