Physicians' Use of Key Functions in Electronic Health Records from 2005 to 2007: A Statewide Survey

Abstract

OBJECTIVE Electronic health records (EHRs) have potential to improve quality and safety, but many physicians do not use these systems to full capacity. The objective of this study was to determine whether this usage gap is narrowing over time. DESIGN Follow-up mail survey of 1,144 physicians in Massachusetts who completed a 2005 survey. MEASUREMENTS Adoption of EHRs and availability and use of 10 EHR functions. RESULTS The response rate was 79.4%. In 2007, 35% of practices had EHRs, up from 23% in 2005. Among practices with EHRs, there was little change between 2005 and 2007 in the availability of nine of ten EHR features; the notable exception was electronic prescribing, reported as available in 44.7% of practices with EHRs in 2005 and 70.8% in 2007. Use of EHR functions changed inconsequentially, with more than one out of five physicians not using each available function regularly in both 2005 and 2007. Only electronic prescribing increased substantially: in 2005, 19.9% of physicians with this function available used it most or all the time, compared with 42.6% in 2007 (p < 0.001). CONCLUSIONS By 2007, more than one third of practices in Massachusetts reported having EHRs; the availability and use of electronic prescribing within these systems has increased. In contrast, physicians reported little change in the availability and use of other EHR functions. System refinements, certification efforts, and health policies, including standards development, should address the gaps in both EHR adoption and the use of key functions.

Readiness for the Patient-Centered Medical Home: Structural Capabilities of Massachusetts Primary Care Practices

“…39 Our findings are consistent with other studies showing that even among these smaller practices, larger size is associated with higher rates of EHR adoption and physician participation in quality improvement. 25,28,40,41 The lack of a consistent relationship between teaching status and structural capabilities may reflect competing organizational priorities within teaching practices. The association between network affiliation and EHR adoption was more complex than for other capabilities.…”

Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

“…Certain types of physicians or practices may be more likely to experience these barriers and have lower adoption rates. [4][5][6][7][8] Recent federal HIT policy initiatives seek to address these barriers, especially among physicians who may not have the means and capabilities to readily adopt HIT. Beginning in 2011, the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 made incentive payments available for eligible physicians who demonstrated 'meaningful use' (MU) of EHRs that possess functionalities capable of meeting specific criteria.…”

Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

“…21,22 Survey items were selected to assess dimensions of health-care quality defined by the Institute of Medicine where prior evidence suggests that electronic health records may play an important role, including patient safety, 23,24 patient-centered care, 25,26 and efficiency, 27 as well as a summary measure of overall quality of care.…”