Performance Improvement 2008. How Widely Have Electronic Health Records Been Adopted?


The study estimated the extent of electronic health record (EHR) adoption in the United States. Leading health information technology experts examined studies and surveys of EHR adoption among physicians and hospitals. They also examined predictors of whether a provider would adopt use of EHRs; the gaps in adoption; how much adoption depended on location, practice size, specialty, or kinds of patients treated; and how the U.S. can collect more precise and timely data on adoption. Highlights included:

 Developing of a standardized definition of adoption based on core functionalities. The team applied this definition to existing surveys to establish a baseline rate of 10 percent for adoption in the physician offices in the United States in 2006. The team also developed a national survey that was administered in 2007 that would allow calculation of future adoption rates.

Establishing approach to measure hospital adoption. There were not enough high-quality, reliable surveys of hospital use of EHRs. The team worked with experts to develop a set of questions which have been adopted by the American Hospital Association as part of their annual survey and will allow the government to measure future hospital adoption rates.

No existence of a digital divide. There remains considerable uncertainty about the existence and size of gaps in use of electronic health records among physicians who care for vulnerable populations. More needs to be done in tracking the adoption and use of EHRs among providers, understanding the unique barriers to adoption, and identifying policies to close these gaps.

Adoption depends on many factors: financial incentives and barriers, laws and regulations, the state of technology and organizational influences such as practice size, hospital or payer mix, and degree of health care system integration.

Report Title: Health Information Technology in the United States: The Information Base for Progress,
Agency Sponsor:
OS-ONC, Office of the National Coordinator for Health Information Technology
Federal Contact:
Kathleen Fyffe, 202-205-0670
George Washington University with Harvard University and the Robert Wood Johnson Foundation
PIC ID: 8580

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"PerformanceImprovement2008.pdf" (pdf, 1.29Mb)

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