Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Assessing the Economics of EMR Adoption and Successful Implementation in Physician Small Practice Settings

Publication Date
Sep 29, 2006

By: Moshman Associates, Booz, Allen, Hamilton

This report is currently only available in PDF format.

Electronic Medical Records (EMRs) are viewed as a means to achieve improved health care quality and reduced costs. In 2004, President Bush announced a lO-year goal of making EMRs available to most Americans. A number of public and private sector initiatives focus on promoting the adoption of HIT such as community-focused initiatives funded by the Agency for Healthcare Research and Quality (AHRQ) and physician-focused initiatives like the Doctor's Office Quality-Information Technology (DOQ-IT) program. Despite these and other initiatives, the adoption of EMRs has been limited with adoption rates varying widely across care settings (rates in ambulatory settings range between 15 and 18 percent). With approximately 75 percent of physician practices employing fewer than nine physicians, such low adoption rates among small practices does not bode well for the national goal of achieving broad EMR diffusion in 10 years. Low rates of EMR adoption have been attributed to a variety of forces including misaligned financial incentives, lack of standardization among EMR applications, and the high turnover of HIT vendors. However, there are few studies that have examined, at a microeconomic level, the various economic and non-economic factors that promote or deter EMR adoption in small practice settings. To provide a deeper understanding of the factors that impede or impel EMR adoption in physicians' small practices, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the Department of Health and Human Services (HHS) engaged Moshman Associates and Booz, Allen, Hamilton to assess the economics ofEMR adoption and implementation in physician small practice settings. This comprehensive report details the findings of the first phase of a two phase study. [PDF - 288 pages]