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EHR use growing, but unevenly


More doctors are using electronic health records, but the growth is faster in some states and practice sizes than others.

Use of electronic health records (EHRs) and other forms of health information technology continues to grow among physicians, but the growth is distributed unevenly in terms of geography and practice size, according to two new studies.

A January 2014 Data Brief on EHR use from the National Center for Health Statistics (NCHS) finds that 78.4% of office-based doctors used an EHR system in 2013. That is the highest percentage ever recorded, and is up from 71.8% in 2012 and 57% in 2011. Meanwhile, a study using data from the Commonwealth Fund International Health Policy Survey of Primary Care Physicians, finds that EHR use among primary care physicians grew from 46% in 2009 to 69% in 2012.

According to the NCHS data, the percentage of doctors with an EHR system that met the criteria for a basic system was lowest in New Jersey (21%) and highest in North Dakota (83%), while the national average was 48%. States trailing the national average included Connecticut, Maryland, Nevada, New Jersey, Oklahoma, Vermont, and Wyoming.       

States that were significantly higher than the national average included Iowa, Massachusetts, Minnesota, North Dakota, Oregon, South Dakota, Utah, Washington, and Wisconsin.

The NCHS also found that only 19% of physicians-and 13% of office-based physicians-both intended to participate in the government’s Meaningful Useprogram (designed to partially offset the cost of acquiring an EHR system) and had EHRs that are able to support 14 of the 17 core objectives included in the second phase of the program (MU2). Doctors can begin attesting to MU2 this year.      

Not surprisingly, practice size correlates closely with EHR use. Half of physicians in solo practices use EHRs, compared with 90% of doctors in practices with 20 or more physicians, according to the Commonwealth Fund study. The adoption rate was higher, however, among solo practices that had resource-sharing arrangements with other practices.

The Commonwealth Fund study also looked at the growth of other forms of health information technology over the 3-year period. It found that the proportion of doctors able to send prescriptions electronically grew from 34% to 66%, and the proportion able to order lab tests electronically increased from 38% to 54%. In addition, in 2012 33% of primary care physicians were able to exchange clinical summaries with other doctors, and 35% could share the results of lab or diagnostic tests with doctors outside their practice.

The Commonwealth Fund study appears in the February 2014 issue of Health Services Research under the title, “Where Are We on the Diffusion Curve? Trends and Drivers of Primary Care Physicians’ Use of Health Information Technology.”



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