Various news outlets ran stories on the New England Journal of Medicine's (NEJM) survey results published yesterday regarding doctors' usage of electronic health record (EHR) in the US. The survey, which involved 2758 doctors, found that while doctors who use EHRs overwhelmingly believe that they improve the timeliness and quality of patient care, less than 20% of all doctors actually are using them.
However, the NEJM survey found that only 4% of US doctors have access to what would be considered to be a "fully functional" EHR system as opposed to a "basic" EHR system. The survey report noted that, "The principal differences between a fully functional system and a basic system were the absence of certain order-entry capabilities and clinical-decision support in a basic system."
The report breaks down usage by medical practice size. Doctors working in medical practices having 50 or more doctors, some 50.5% of those practices have installed EHR systems. Those with 11 to 50 in the practice, the percentage drops to 29.3%. Those medical practices consisting of 1 to 3 doctors, the percentage which have installed EHR systems is only 8.6%.
Unsurprisingly, the main reason for the low EHR adoption rate is mainly financial, although other factors were cited in the NEJM survey report: "Among physicians who did not have access to an electronic-records system, the most commonly cited barriers to adoption were capital costs (66%), not finding a system that met their needs (54%), uncertainty about their return on the investment (50%), and concern that a system would become obsolete (44%)."
Without major financial incentives, I don't see the wide-spread adoption of EHR systems in the US anytime soon, and definitely not by the 2014 deadline President Bush set out in 2004.
