Few doctors have implemented, effectively use electronic health records

About one in four physicians use some type of electronic health records, while fewer than one in 10 use a comprehensive EHR system, according to a study that suggests "a technology frequently billed as a way to improve the quality and efficiency of care has yet to win widespread acceptance," the Washington Post reports (Lee, Washington Post, 10/12).

The study was funded by the Robert Wood Johnson Foundation and the Office of the National Coordinator for Health Information Technology at HHS (CongressDaily, 10/11). For the study, researchers from Massachusetts General Hospital and George Washington University examined surveys completed since 1995 to determine the current extent of EHR usage (Washington Post, 10/12). The study found that no reliable data exists on the percentage of hospitals that have adopted EHRs. However, about 5% of hospitals used computerized physician order entry systems, according to the study. Overall, 23.9% of physicians providing care in nonhospital settings used some form of EHRs, while about 9% used "fully operational" systems that collect patient information, display test results, allow physicians to order medications and assist providers in making treatment decisions, the study found.

Additional Findings

Physicians who treat large numbers of Medicaid beneficiaries were half as likely as other physicians to have adopted EHRs, according to the study (Reichard, CQ HealthBeat, 10/11). The study also found that physicians in private practices or in practices with one other physician were much less likely than other physicians to have adopted EHRs. About half of U.S. physicians practice in such settings, according to co-author Ashish Jha, an assistant professor at the Harvard School of Public Health (Washington Post, 10/12). In addition, the study found that physicians in cities, those in larger practices and those in large health care facilities were most likely to have adopted EHRs, according to co-author David Blumenthal, director of the Institute for Health Policy at Massachusetts General. The study also included standard definitions of "electronic health record system" and "adoption." The study states that "for policy makers to understand the effectiveness of efforts to improve EHR adoption, we will need ongoing tracking with high-quality surveys." John Lumpkin, a senior vice president at RWJF, said the researchers plan to conduct a follow-up study next year (CQ HealthBeat, 10/11).

Comments

Blumenthal said, "This is a kind of tipping-point phenomenon, where if you get to a certain point, it might really take off." He added, "We just don't know where we are with respect to that potential tipping point" (Washington Post, 10/12). Blumenthal said the study shows that current EHR use levels "are pitifully behind where we should be" (CQ HealthBeat, 10/11). President Bush has called for most U.S. residents to have EHRs by 2014 (Washington Post, 10/12). At the current rate of adoption, about half of physicians would have functional EHRs by that time, Blumenthal said. Karen Bell, director of the Office of Health IT Adoption at ONC, said the low rate of EHR adoption "doesn't surprise us." She added, "We know that there has been an issue with the adoption of electronic health records for some time and that the adoption gap is very prevalent as well." Myrl Weinberg, president of the National Health Council, said patient awareness of EHRs "will be the most important element of that tipping point." Weinberg added, "As [patients] become familiar with the advantages to them, they start talking with their friends" (CQ HealthBeat, 10/11). Deborah Peel, founder of Patient Privacy Rights, said, "The big problem is that the vast majority of electronic medical record systems do not give patients the right to decide who has access to the records," adding, "They do not give patients the right to segment sensitive portions. ... The electronic medical records in use now have been designed primarily for the convenience of physicians" (Washington Post, 10/12).

The report is available online. Note: You will need Adobe Acrobat Reader to view the report.