Health Information Technology

Adoption rates of electronic health records are low among physician groups

A comprehensive study by the Medical Group Management Association (MGMA) Center for Research and the University of Minnesota School of Public Health has captured the current state of adoption of electronic health records (EHR) by U.S. medical group practices. More than 3,300 medical group practices were surveyed in the Assessing Adoption of Health Information Technology project, which was supported by the Agency for Healthcare Research and Quality (Contracted 290-00-0017).

The survey, conducted in January and February 2005, indicates that just 14.1 percent of all medical group practices use an EHR, and just 11.5 percent have an EHR fully implemented for all physicians and at all practice locations. Only 12.5 percent of medical group practices with five or fewer full-time-equivalent physicians (FTE) have adopted an EHR. The adoption rate increased with the size of practice: groups with 6 to 10 FTE physicians reported a 15.2 percent adoption rate; groups with 11-20 FTE physicians reported an 18.9 percent adoption rate; and groups of 20 or more FTE physicians had a 19.5 percent adoption rate.

About 13 percent of groups were in the process of implementing an EHR, 14.2 percent said implementation is planned in the next year, and 19.8 percent said implementation was planned in 1 to 2 years. The remaining 41.8 percent have no immediate plans for EHR adoption. Among those with no immediate plans for implementation, the difference between large and small groups is striking—47.8 percent of practices with five or fewer FTE physicians compared with only 20.7 percent of practices with 21 or more physicians.

Group practices cited lack of capital resources to invest in EHR as the top barrier to adoption. Researchers noted an important barrier to adoption is that practices are not convinced EHRs will improve their performance. They also note that the return on investment in terms of cost and quality is not yet evident.

The average purchase and implementation cost of an EHR was $32,606 per FTE physician. Maintenance costs were an additional $1,500 per physician per month. Smaller practices had the highest implementation cost per physician at $37,204. Researchers also found that the average cost for EHR implementation was about 25 percent more than initial vendor estimates.

See "Medical groups' adoption of electronic health records and information systems," by David Gans, John Kralewski, Terry Hammons, and Bryan Dowd, in the September/October 2005 issue of Health Affairs, pp. 1323-1333.

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