Last November, we released data from the 2011 National Ambulatory Medical Care Survey (NAMCS) of office-based providers, finding that 57 percent had adopted an electronic health record (EHR), and 34 percent met all criteria for “basic EHR use” (patient history and demographics, patient problem list, physician clinical notes, comprehensive list of patient’s medications and allergies, computerized orders for prescriptions, and ability to view laboratory and imaging results electronically). 

Physicians and EHR Adoption

In this follow up analysis of a supplement to the 2011 survey, our colleagues at NCHS delve deeper into the experiences of those who have adopted an EHR, and those who have not. Among those physicians who have not yet adopted an EHR, an additional 48 percent are either in the midst of adopting or plan to adopt an EHR in the coming months. Going far beyond just the “early adopters,” this data shows that EHRs are taking hold among a larger number of providers who believe that the use of technology leads to better, safer, more coordinated health care.

These findings are in spite of the fact that I often hear from providers who are dissatisfied with their EHR systems. These providers tell me that that their systems don’t work correctly and present significant workflow challenges with little potential to improve patient care. The data released today asks about those concerns and finds, through rigorous, scientific surveying and analysis, a small portion (15 percent) of those who have adopted EHRs have those concerns.

Experiences with EHR Adoption

In fact, after completing EHR adoption, most providers have had positive experiences using their system. NCHS reports that 85 percent of the physicians surveyed indicated they were either very satisfied or somewhat satisfied with their EHR and almost three-quarters (74 percent) reported that their use of an EHR within the last 30 days enhanced their overall patients’ care. Almost three-quarters (71 percent) would purchase their EHR system again.

Physicians also reported a variety of specific benefits—both for themselves and their patients—from the use of their EHR systems. Half of those physicians who have adopted EHRs reported being alerted to critical lab values (i.e. lab results that fall above or below the normal range) and more than 40 percent were alerted to potential medication errors. Almost three-quarters of EHR adopters reported that within the last 30 days they accessed their patients’ charts remotely, improving care and enhancing patient safety by providing the physician access to critical information when he or she is offsite, or after hours.

While the data highlights both the widespread EHR adoption and significant benefits of EHRs, just as importantly, it points out opportunities for improvement. Less than one-third of physicians reported that their EHR helped them identify needed lab tests, and only a quarter of EHR adopters reported using their EHR in the last 30 days for patient communications.

Next Steps for EHR Adoption

We are taking action to address these issues. Recently, ONC announced an initiative to use the DIRECT project to send lab results directly to EHRs. Additionally, the proposed requirements for Stage 2 meaningful use build on the Stage 1 requirements with an emphasis on standards-based information exchange and patient and family engagement. As payment models such as Accountable Care Organizations become more widespread, these features will become ever more necessary as a foundation for delivery transformation.

While more work certainly needs to be done, today’s data shows that most physicians are satisfied with their EHRs and believe that their systems provide tangible benefits for patients today. This will only increase as physicians become more skilled at using their systems and systems continue to evolve to support additional capabilities.

For more information about health information technology, visit HealthIT.gov.