How many more doctors are using electronic medical records?

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent,

Just over 40% of office-based physicians reported using electronic health record (EHR) systems in 2008, more than double the percentage at the start of the decade.

How many more doctors are using electronic medical records? From 2007 to 2008, usage of EHRs increased by nearly 19% according to the National Ambulatory Medical Care Survey (NAMCS), conducted by the National Center for Health Statistics (NCHS), and preliminary data for 2009 show the increase continuing, with 44% of physicians reporting using an EHR.

In 2001, only about 18% had an EHR. The decade long growth and the steeper rate of increase in the last half of the decade bode well for the government’s push to have EHRs for most Americans by 2014.

On Dec. 30, 2009, the Obama administration released details of its program to encourage adoption of EHRs by physicians and hospitals. The Department of Health and Human Services (HHS) posted two major notices intended to flesh out the broad program authorized by the so-called HITECH Act, part of the 2009 economic stimulus package, which provided nearly $20 billion to promote use of EHRs and other health information technologies.

Despite the overall growth in EHR implementation, the most robust systems are still in only a small fraction of physician practices.

In 2008, about 17% of physicians reported they had a “basic” EHR system, which included having computerized patient demographic information, patient problem lists, clinical notes, orders for prescriptions, and laboratory and imaging results. That figure is a 41% increase from the previous year.

Just 4.4% reported having a “fully functional” EHR — the kind envisioned by most healthcare advocates. Fully functional systems include all the elements of the “basic system,” but also the ability to take, store, and follow-up on a patient’s medical history, order tests, and send prescriptions electronically. Such systems also alert the physician about drug interactions or contraindications, highlight out-of-range test levels, and provide reminders for guideline-based interventions.

The newly-issued EHR standards specify that systems would need most of those basic functions by 2011 to qualify for financial incentives.

The NAMCS is an annual nationally representative survey of patient visits to office-based physicians that collects information on use of EMRs/EHRs. The 2008 survey was conducted via an in-person interview with 3,200 physicians. Another 2,000 received a mail survey.

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