WASHINGTON - Findings released Wednesday from a first-ever, comprehensive study on the use of electronic health records in the United States revealed that 24.9 percent of physicians use some form of loosely defined EHRs, although fewer than 10 perrcent employ what researchers define as “a system most likely to benefit patient care.”
The 81-page report, Health Information Technology in the United States: The Information Base for Progress, also showed that only 5 percent of hospitals use computerized physician order entry (CPOE) systems, an indicator of EHR adoption in the in-patient setting.
“These findings come as no surprise,” said Karen Bell, M.D., director of the Office of Health IT Adoption, Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services (HHS). “We’ve known this for a long time.” Bell suggested it is unlikely the nation will achieve President Bush’s goal of electronic medical records for most Americans by 2014.
“The study does, however, set up an important baseline for assessing progress and a standard by which to measure healthcare IT implementation in future studies,” Bell said. In addition, major changes in the industry over the next several years could tip the rate of implementation closer to the 2014 goal, she noted.
Ashish Jha, M.D., a researcher on the project and assistant professor at Harvard School of Public Health said hospitals cite two main reasons for not adopting EHR systems: expense, and disruption to care during implementation.
Aside from costs, the study revealed several additional barriers to EHR adoption, including fear of legal burdens, technical concerns about use, and the fear that systems could become obsolete too quickly through vendor mergers or technology upgrades.
The study also revealed that physicians from solo or two-partner practices were least likely to use EHRs. This is a concern because more than half of U.S. physicians work in one or two-person practices, Jha said. Providers in rural areas are least likely to adopt EHRs, along with those serving vulnerable and minority populations.
The report was jointly commissioned by HHS and the Robert Wood Johnson Foundation, with research conducted by George Washington University Medical Center and the Institute for Health Policy at Massachusetts General Hospital/Partners HealthCare System. A companion article entitled, “How Common Are Electronic Health Records in the United States? A Summary of the Evidence” was published online in Health Affairs.
Researchers hope to use the study to monitor the adoption of EHRs, improve outcomes and reduce medical errors, and to minimize healthcare disparities. Results from a follow-up study are expected by fall 2007, researchers said.
