Rates of electronic health-record system adoption among office-based physicians grew significantly in 2011, according to a national report card on EHR adoption.
EHR adoption for office docs at 57%: survey
In a survey conducted by the National Center for Health Statistics between February and June, 56.9% of physician respondents said their practice uses electronic health records in some capacity other than for billing. That's up from the 50.7% of respondents who replied the same in 2010 (PDF). In addition, 52% of respondents this year said their practice was planning to apply for federal EHR incentive payments, up from 41% who said the same in 2010.
The NCHS, an arm of the Centers for Disease Control and Prevention, has been measuring EHR adoption since 2008 as part of its National Ambulatory Medical Care Survey program. The latest numbers are based on mail surveys conducted with a sample of 10,301 physicians.
In this year's survey, the NCHS found increases in the self-defined use of "any" EHR system and in the adoption of "basic" EHR systems. About one-third (33.8%) of respondents this year said their practice was using a basic EHR system. That reflects an increase from 24.9% in the 2010 survey, which was conducted between April and July 2010.
A basic system is defined in the 2011 survey report as one that is able to record and store patient history and demographics information; compile problem lists, physician clinical notes, patient medication lists and allergy lists; order prescriptions electronically; and view labs and images.
In 2010, a basic system had only seven functions—all of the above, except for being able to compile allergy lists.
Missing from the 2011 report is a mention of adoption rates for "fully functional" EHR systems. The 2010 report listed the penetration rate of a fully functional EHR at 10.1%.
It was Dr. David Blumenthal, before he became head of the Office of the National Coordinator for Health Information Technology at HHS, who came up with the current method used by the NCHS of defining an EHR by a fixed set of functions.
After consulting with industry experts, Blumenthal who headed the Institute for Health Policy at Massachusetts General Hospital, Boston, which was working under a research contract funded by federal and private sources, came up with a list of 16 functions to constitute a fully functional EHR. They included all of the basic functions, but also listed advanced clinical decision-support features such as clinical guidelines and drug-interaction alerts as well as interoperability functions, including the ability to electronically order lab and radiology tests. The list was used in an institute survey conducted between September 2007 and March 2008 and reported that June.
The adoption level for fully functional EHRs in that initial survey was only 4%, and Blumenthal's researchers decided to give physicians partial credit for adopting a basic system with fewer functions, which pushed the rate to 13%. Blumenthal's methodology was handed over to the NCHS for future survey work.
Esther Hing, an NCHS survey statistician and co-author of the most recent survey report, said the center "really gearing up toward what are the EHRs that physicians are going to be using when physicians are going to be applying for meaningful use."
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