Health Information Technology

Few medical practices have electronic health records, and clinicians don't make full use of them

Less than one in five office-based medical practices have adopted electronic health records (EHRs). To get a better understanding of the factors that are associated with EHR use and with barriers to use in ambulatory practices, researchers surveyed a random sample of office practices in Massachusetts. Of the 847 practices that responded to the survey, only 18 percent were using EHRs. The researchers found no significant difference in use between primary-care-only and mixed primary/specialty practices (23 percent versus 25 percent). However, the adoption rate for EHR was significantly lower for specialty-only practices (14 percent). Use of EHRs increased with the size of the practice, with fewer small practices adopting the technology. Even among adopters of the technology, the use of various EHR functions differed widely.

The researchers found that 74 percent of the EHR practices used electronic visit notes, followed by online lab test results and medication lists (both 64 percent). In contrast, radiology order entry was available via the EHRs of 40 percent of the practices, but used by more than half the physicians in such practices. The majority of practices without an EHR (52 percent) had no plans to implement one in the foreseeable future, with solo practices being the least likely to implement the technology (70 percent had no plans). Lack of adequate funding was cited as a barrier to implementation by 42 percent of the non-EHR practices, with other barriers ranging from lack of physician support for change (28 percent) to inability to find a system that met the practices' needs (20 percent).

The study was funded by a grant from the Agency for Healthcare Research and Quality (HS15397).

For more information, see "Electronic health records: which practices have them, and how are clinicians using them?" by Dr. Simon, Madeline L. McCarthy, M.Sc., of Brigham and Women's Hospital, Rainu Kaushal, M.D., M.P.H, of Cornell University's Weill Medical College in New York City, and others in the February 2008 issue of Journal of Evaluation in Clinical Practice 14(1), pp. 43-47.

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