rss
JAMIA 2007;14:110-117 doi:10.1197/jamia.M2187
  • Original Investigation
  • Research Paper

Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey

  1. Steven R Simon,
  2. Rainu Kaushal,
  3. Paul D Cleary,
  4. Chelsea A Jenter,
  5. Lynn A Volk,
  6. Eric G Poon,
  7. E John Orav,
  8. Helen G Lo,
  9. Deborah H Williams,
  10. David W Bates
  1. Affiliations of the authors: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care (SRS), Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital (RK, CAJ, EJO, DHW, DWB), Clinical and Quality Analysis, Partners HealthCare System, Inc. (LAV, EGP, HGL, DWB), and the Department of Health Care Policy (PDC), Harvard Medical School, Boston, MA
  1. Correspondence and reprints: Steven R. Simon, MD, MPH, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA 02215, USA; Tel: (617) 509-9938; Fax: (617) 859-8112; e-mail: <steven_simon{at}hphc.org>
  • Received 24 June 2006
  • Accepted 21 September 2006

Abstract

Objective Despite emerging evidence that electronic health records (EHRs) can improve the efficiency and quality of medical care, most physicians in office practice in the United States do not currently use an EHR. We sought to measure the correlates of EHR adoption.

Design Mailed survey to a stratified random sample of all medical practices in Massachusetts in 2005, with one physician per practice randomly selected for survey.

Measurements EHR adoption rates.

Results The response rate was 71% (1345/1884). Overall, while 45% of physicians were using an EHR, EHRs were present in only 23% of practices. In multivariate analysis, practice size was strongly correlated with EHR adoption; 52% of practices with 7 or more physicians had an EHR, as compared with 14% of solo practices (adjusted odds ratio, 3.66; 95% confidence interval, 2.28–5.87). Hospital-based practices (adjusted odds ratio, 2.44; 95% confidence interval, 1.53–3.91) and practices that teach medical students or residents (adjusted odds ratio, 2.30; 95% confidence interval, 1.60–3.31) were more likely to have an EHR. The most frequently cited barriers to adoption were start-up financial costs (84%), ongoing financial costs (82%), and loss of productivity (81%).

Conclusions While almost half of physicians in Massachusetts are using an EHR, fewer than one in four practices in Massachusetts have adopted EHRs. Adoption rates are lower in smaller practices, those not affiliated with hospitals, and those that do not teach medical students or residents. Interventions to expand EHR use must address both financial and non-financial barriers, especially among smaller practices.

Footnotes

  • Presented in abstract form at the 29th Annual Meeting of the Society of General Internal Medicine, April 2006, and at the HMO Research Network Conference, May 2006.

  • This project was supported by grant number 1 UC1 HS015397 from the Agency for Healthcare Research and Quality.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. Data Supplement

Responses

  1. Submit a response
  2. No responses published

Access policy for JAMIA

All content published in JAMIA is deposited with PubMedCentral by the publisher but with varying embargo times. Authors/funders may pay an Unlocked fee of $2,000 to make the article free on the JAMIA website and PMC immediately on publication. Research funded by government and other recognised agencies is deposited with a 12 month embargo. All other content is deposited with a 36 month embargo.

The Journal of the American Medical Informatics Association is published for the American Medical Informatics Association by BMJ Publishing Group Ltd.