Physician use of electronic health records continued to grow in Texas last year, with younger doctors and primary-care physicians leading the charge with indirect access specialists—such as anesthesiologists and emergency medicine doctors—lagging behind, according to a survey by the Texas Medical Association. The survey also found that purchase, training and implementation costs are dropping and that almost 60% of the respondents reported interest in qualifying for the EHR subsidies included in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law. Forty-three percent of the 370 physicians surveyed said they use an EHR compared with 33% in 2007 and 27% in 2005. The number of respondents wanting to implement an EHR system was virtually unchanged: 41% in 2009 compared with 40% in 2007. But the number of physicians who said they had no plans to implement a system fell to 16% in 2009 from 25% in 2007. According to the survey, 60% of respondents under age 40 are using an EHR compared with 48% in 2007 and 37% in 2009. The survey found that, among respondents currently using an EHR, the median purchase, training and implementation costs fell to $18,000 in 2009 compared with $25,000 in 2007; and monthly maintenance cost decreased to $350 from $425 during the same period. When asked what they liked the most about their systems, 76% of EHR-using respondents said electronic charting, while half cited awkward or time-consuming data input as what they liked the least about their systems. Among physicians who plan to implement an EHR, 14% are in some stage of implementation (up from 11% in 2007); 16% plan to do so within six months (compared with 17% in 2007); 22% plan to implement in six to 12 months (down from 24% in 2007); 35% plan to implement an EHR in one to two years (down from 37% in 2007); and 13% said it will be more than two years before they do so (up from 11% in 2007). Of the respondents who said they had no plans to implement an EHR, 72% cited prohibitive costs—up from 63% in 2007. Among all respondents, 59% said that they would try to qualify for federal EHR subsidies by showing that they are putting their systems to meaningful use. The survey was conducted in October and November 2009, and it had a 4% response rate from more than 10,000 physicians who received the survey in either e-mail or paper formats.
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