Landmark Survey Finds Low Rates of Physician EHR Adoption

New research published Wednesday in the New England Journal of Medicine found that fewer than 20% of U.S. physicians use some form of electronic health records, the New York Times reports.Experts say the study, funded by HHS and the Robert Wood Johnson Foundation, is more definitive than previous research because it is based on a larger sampling and a detailed survey. Fifty-one percent of physicians in practices of 50 or more doctors said they use EHRs, while fewer than 9% of physicians in small practices reported using EHRs.Physicians surveyed cited cost as the primary barrier to EHR adoption (Lohr, New York Times, 6/19). The study's authors estimate that the cost of transitioning from paper records to EHRs is about $60,000 (Davis, USA Today, 6/19).In addition, 54% of physicians without EHRs said that finding an EHR system that met their needs was a "major barrier" to adoption. Doctors also cited the time-consuming transition to EHRs as a barrier (New York Times, 6/19).
Findings
The survey of 2,758 physicians nationwide found that:
42% said their office had purchased an EHR system but had not yet deployed it or were planning to purchase one in the next two years;
13% said they had a basic or partially functional EHR system; and
4% said they had a fully functional EHR system (Ferris, Government Health IT, 6/18).Of the surveyed physicians who use EHRs, the survey found:
86% said the systems helped to avoid medication errors;
85% said they improved the delivery of preventive care;
82% said using EHRs improved the quality of clinical decisions (New York Times, 6/19); and
About 60% of physicians who use more basic EHR systems responded positively to them (Alesci, Bloomberg News, 6/19).The survey also found that physicians who treat more affluent patients were just as likely to adopt EHRs as those who treat low-income patients, although the study's co-author, David Blumenthal, said more research is necessary to ensure there is not a disparity (USA Today, 6/19).The researchers who oversaw the survey recommended that policy leaders look for guidance from other countries whose cost-sharing strategies have boosted EHR adoption into the 90% range. The survey was conducted between September 2007 and March 2008 (Conn, Modern Healthcare, 6/18). Karen Bell, director of HHS' Office of Health IT Adoption, said CDC will repeat the survey using the same survey instrument in the future (Government Health IT, 6/19).
Reaction
Catherine DesRoches of Massachusetts General Hospital in Boston and the lead author of the study, said, "Clearly the results show we are a long way from universal adoption by 2014." President Bush has set a goal for most U.S. residents to have EHRs by 2014 (Steenhuysen, Reuters, 6/18).Bell said she is "heartened" by the growing response among physicians to adopt EHR systems, noting, however, that the study shows "we are a long way from universal adoption" (USA Today, 6/19).Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital, said, "We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine" (Government Health IT, 6/18).David Brailer, former National Coordinator for Health IT, called the findings "very encouraging" but noted that doctors are unsatisfied with existing EHR products. He said, "What we see is a deficit in innovation, and that is something innovators and the capital market can address" (New York Times, 6/19).