The widespread use of electronic health records has significant potential to improve health care quality. Yet according to a new study conducted by MIHP, only 4% of physicians in the United States who provide direct patient care report using a fully-functioning electronic records system.  This contrasts starkly with many industrialized countries, where most primary care physicians use computers in their practices.

This definitive study, supported by the Department of Health and Human Services and the Robert Wood Johnson Foundation and published in the New England Journal of Medicine (July 12, 2008), assessed physicians’ adoption of electronic health records, their satisfaction with them, perceived effects on quality of care, and barriers to adoption. This is the first study to delineate key functions of outpatient electronic health records with input from a panel of experts and to develop benchmark survey items for future studies to accurately measure diffusion of electronic health records.

According to Principal Investigator Dr. Catherine DesRoches, previous studies have used disparate measures and survey methods: “Our initial goal was to develop agreed-upon measures and to use those measures in a national survey to get to the real baseline.  This benchmark information can be reliably used to inform health care policy going forward.”

Of the small number of physicians in private practice who reported utilizing a fully-functional health information system, most were younger doctors who worked in large group practices, hospitals, or medical centers.  The vast majority of these respondents reported that electronic information systems had a positive impact on quality of clinical decisions, communication with patients and other providers, and avoidance of medication errors.

The most commonly-cited barriers to adoption were cost, inability to find a suitable system, uncertainty about return on investment, and fears that a system would become obsolete.  These responses suggest that financial incentives could assist in spurring adoption.

The study was cited in a recent New York Times editorial calling for leadership from policymakers, including funding, to accelerate conversion to electronic records and urging private physicians to embrace the technology.  According to the Times, failure to adopt available technology more widely jeopardizes health care reform and achievement of national health goals.

Please click on the following weblink to review the full text of the New England Journal of Medicine article:

http://content.nejm.org/cgi/content/full/359/1/50