Federal regulations as part of American Recovery and Reinvestment Act (ARRA) of 2009 provide thirty (30) billion dollars of incentives in the form of additional Medicare and Medicaid reimbursement for physicians who can demonstrate “meaningful use” of “certified” EHR or electronic health records technology. Payments to physicians as part of this program started in May 2011. Physicians who practice sports medicine are eligible to receive such payments provided that their clinical information systems meet government requirements. These incentives have created a new market opportunity for software vendors who can best meet the needs of sports medicine practices.
Sports medicine practices are in many respects similar to other medical specialties and practices. Physicians, allied health professionals, and various personnel provide healthcare and associated support services for patients or, more specifically in sports medicine, patient athletes. In the sports medicine setting, patient appointments are scheduled, diagnoses are made, treatments are prescribed, and results are documented, just as in other medical practices.
There are also many special needs and considerations for sports medicine practices including, among others: the documentation of pre-participation exams and re-entry to play approvals, the capture and storage of pertinent communications between providers and other members of the sports medicine team, specialized order sets and reporting templates, the capture and accessibility of data at the point-of-care and the need to perform outcome data/analysis specific to athletes and sports medicine.
Currently, there are no known dedicated or specialized information system designed to meet the needs of these sports medicine practices nor is there any known organized effort to define standards for “sports medicine information systems” or “SMIS,” both terms coined by the author to refer to computerized clinical information systems specifically designed to meet the needs of sports medicine. Recent research conducted by the author was aimed at determining the potential size of the market for sports medicine information systems, the level of interest in sports medicine information systems, the specific needs of sports medicine practices, and how well current systems are meeting those needs. The research included a comprehensive literature review and implementation of a detailed survey instrument delivered to sports medicine practices throughout the United States.
In many respects, the survey results were consistent with many of the findings in the literature review. The rate of EHR adoption among respondents was very similar to that reported in surveys referenced in the literature review. However, the EHR adoption rate is expected to grow in the coming months with recent government incentives. Even with the new incentives in place however, only sixty-three (63) percent of medical practices had implemented a certified EHR to date. For those groups that cannot take advantage of the government incentives (for example, those with very small Medicare/Medicaid populations), the business case to adopt EHR will likely depend upon process efficiencies that can be attained as well as the marketing value of such technology.
The perceived need for sports medicine information or sports medicine informatics was expressed through specific survey questions about 1) the degree to which the respondent believed there was in fact a need, 2) the frequency with which the respondent had to deploy supplemental processes or systems to meet their needs, 3) which sports medicine-specific functions (as proposed by the researcher) were included in the respondents’ current systems, and 4) the perceived importance of each sports medicine-specific function proposed by the researcher.
The majority of all respondents indicated that every sports medicine-specific proposed by the researcher was at least somewhat important. Yet, in a separate question, no single feature on that list was indicated as part of any current system for more than twenty-five (25) percent of respondents. Interpreted together, both questions clearly indicate a functionality/needs gap. These results were not surprising because, as noted earlier, the researcher could not identify any commercially available products currently available to meet these needs.
Busier practices were predictably more likely to suggest that the need for sports medicine information systems exists, as were practices that saw a higher volume of sports medicine cases or that performed or referred a higher percentage of medical imaging studies. Practices that have outreach programs in place were also more likely to express a need for sports medicine information systems. These results were not surprising. Practices with higher volumes are expected to achieve the greatest benefits from EHR implementation through increased efficiencies and better information availability. Practices with multiple offices and/or with extensive outreach programs stand to benefit the most from information available anytime and anywhere. Practices that utilized more radiology resources naturally want the digital medical images integrated within the patient’s medical record. Finally, those practices that perform a higher percentage of sports medicine-related services would understandably want to be served by a dedicated product.
In total, this research arrived at several major conclusions:
- There are a host of benefits that medical practices can achieve when implementing electronic health records (EHR).
- Sports medicine has very specialized needs not typically found in “off-the-shelf” clinical information systems.
- Based on the results of a thorough literature review, there is little to no commercial effort to meet the specific informatics needs of sports medicine, nor is there any identified organized effort to create or support a specialized field of “sports medicine informatics.”
- Recent government incentives will likely have a huge impact on EHR adoption in all of healthcare, including sports medicine.
- Although many sports medicine practices have computerized clinical information systems in place, and in some cases even “certified EHR” technology in place, those practicing sports medicine indicate a clear need for dedicated sports medicine information systems.
- Larger practices that perform a higher percentage of sport medicine services, have multiple offices, utilize more medical imaging, and operate outreach programs are more likely to perceive a need for dedicated sports medicine information systems.
- The data suggests that there is a potentially large market for vendors who develop dedicated sports medicine information systems.
Dr. Mark Janas is the Managing Partner and CEO of In3, Inc. a technology and business development firm based in Raleigh, NC with holdings in multiple minor league basketball teams and sport-related businesses including ScoreTrax.com. He is also a graduate of the doctoral program in sports management at the United States Sports Academy.