Office-based Physician Electronic Health Record Adoption, 2008-2024

In 2009, the HITECH Act was enacted to, among other federal health IT priorities, invest in health IT adoption and use among hospitals and office-based physicians. Beginning in 2011, office-based physicians began to receive incentive payments to adopt health IT certified by the ONC Health IT Certification Program. Prior studies have shown the impact of HITECH investment on physician EHR adoption, showing steady growth before HITECH and significant increases after incentive payments were first issued in 2011.(1,2) This data brief provides a deeper analysis of this data over time with a particular focus on the latest adoption data collected in 2024 as part of the National EHR Survey (NEHRS), which showed continued growth through 2024. The brief features analysis and results stratifying certified EHR adoption by physician and physician practice characteristics, showing variation in adoption patterns across physician settings and scope of practice. This brief also represents ONC’s final formal reporting of physician EHR adoption statistics. Although there is still work ahead to advance and evolve health IT, the data in this brief show broad, nearly ubiquitous EHR adoption among office-based physicians – a strong digital foundation to continue advancing healthcare through technology.

Highlights

• Nine in ten physicians reported use of a certified EHR in 2024, up from 4 in 10 physicians who used any EHR in 2008.
• Physicians in large practice groups were more likely to use an EHR.
• EHR developer market share is generally the same across primary care, medical, and surgical specialists.
• Market share differed greatly by practice size with larger practices much more likely to use a market-leading EHR and smaller practices more likely to use a wider range of EHRs.
• Market share differed greatly by practice ownership with physicians working in academic medical centers, HMOs, and hospitals much more likely to use a market-leading EHR.

Nine in ten physicians reported use of a certified EHR in 2024, up from 4 in 10 physicians who used any EHR in 2008.

Findings

• Ninety-five percent of physicians report use of “Any” EHR.
• The gap between adoption of “Any” EHR and a “Certified” EHR narrowed since 2014.

Figure 1: Percent of office-based physicians who adopted any type of EHR or certified EHR, 2008-2024

Source: National Electronic Health Record Survey (2012 – 2024). National Ambulatory Medical Care Survey (2008-2010).
Notes: See Methods and Definitions for further details on the calculation of these metrics and terminology. All percentages are weighted. More physicians may have a certified EHR than measured due to respondent knowledge about the underlying capabilities and certification of their technology. See the Methods section for further details about how the “Certified” EHR metric was estimated and potential under estimation based on respondent recall

Physicians in large practice groups were more likely to use an EHR.

Findings

• Physician specialties adopted EHRs at similar rates.
• Physicians practicing in hospital, academic medical center and FQHC-owned or affiliated groups adopted EHRs at higher rates than physician-led groups.

Table 1: Percent of office-based physicians who adopted any type of EHR or certified EHR, by physician characteristics, 2024.

Physician characteristic	% Any EHR	% Certified EHR
Specialty
Primary Care (ref)	95.9%	92.0%
Medical	93.7%	88.7%
Surgical	95.3%	92.5%
Group size
1 physician (ref)	86.1%	79.9%
2–3 physicians	94.2%*	90.2%*
4–10 physicians	97.9%*	92.9%*
11–50 physicians	98.4%*	95.1%*
51+ physicians	99.1%*	98.5%*
Ownership
Physician-led (ref)	92.8%	87.0%
HMO	98.4%*	98.4%*
FQHC	98.8%*	98.8%*
Academic	99.6%*	98.8%*
Other hospital	98.4%*	98.4%*
Other health care corporation	97.3%*	92.8%*
All others	88.1%*	77.8%*

Source:  2024 National Electronic Health Record Survey, N = 1,725.
Notes: See Methods and Definitions for further details on the calculation of these metrics and physician characteristics. All percentages are weighted. * Significantly different from reference category. See Appendix Table 1 for weighted respondent proportions by physician characteristic.

EHR developer market share is generally the same across primary care, medical, and surgical specialists.

Findings

• Primary care physicians (PCPs) were slightly more likely than other specialists to adopt an EHR from one of the top five EHR market leaders.
• Medical and surgical specialists were slightly more likely than PCPs to adopt an EHR from a midmarket or other EHR developer.

Figure 2: Percent of office-based physicians who adopted an EHR, by specialty and EHR developer market share.

Source: 2024 National Electronic Health Record Survey, N = 1,725.
Notes: See Methods and Definitions for further details on the calculation of these metrics and specialty terminology. All percentages are weighted. See Appendix Table 1 for weighted respondent proportions by physician specialty. See Appendix Table 2 for EHR developer groupings.

Market share differed greatly by practice size with larger practices much more likely to use a market-leading EHR and smaller practices more likely to use a wider range of EHRs.

Findings

• Physicians in solo practices are more likely to adopt an EHR from an extensive market of EHRs from small developers than a market-leading developer. They are also more likely to not adopt an EHR.
• Ninety percent of physicians who practice in groups of more than 50 physicians used an EHR from 1 of 5 market leading developers.

Figure 3: Percent of office-based physicians who adopted an EHR, by practice size and developer market share.

Source: 2024 National Electronic Health Record Survey, N = 1,725.
Notes: Practice size ranges were given response options in the survey. See Methods and Definitions for further details on the calculation of these metrics. All percentages are weighted. See Appendix Table 1 for weighted respondent proportions by practice size. See Appendix Table 2 for EHR developer groupings.

Market share differed greatly by practice ownership with physicians working in academic medical centers, HMOs, and hospitals much more likely to use a market-leading EHR.

Findings

• Physicians in physician-owned practices and physicians under other ownership are much more likely than other physician types to adopt an EHR from a non-market leading developer. They are also more likely to not adopt an EHR.
• Physicians who practiced as part of a FQHC are more likely to use a market-leading EHR than physician-owned groups but report a greater mix of technology than physicians who practiced under hospital and medical center ownership, who are much more likely to use a market-leading EHR.

Figure 4: Percent of office-based physicians who adopted an EHR, by ownership and developer market share.

Source: 2024 National Electronic Health Record Survey, N = 1,725.
Notes: See Methods and Definitions for further details on the calculation of these metrics and ownership terminology. All percentages are weighted. See Appendix Table 1 for weighted respondent proportions by ownership. See Appendix Table 2 for EHR developer groupings

Summary

The rapid digitization of medical records by office-based practices has enabled patients to access their medical records through smartphone apps, has enabled electronic health information exchange via networks and other methods, and has allowed for the use of artificial intelligence in clinical care. Prior to the passage of the HITECH Act, less than half of physicians reported use of any type of EHR. Data show that in 2008 fewer than 20% of physicians adopted an EHR that enabled the technological capabilities included as part of the “Basic” EHR measure, an early metric that tracks the use of technology with advanced capabilities for patient access, information exchange, and clinical documentation.(2,3) By 2024, fifteen years after HITECH became law, 91% of physicians used a certified EHR and an additional 4% used an EHR that did not meet the certification requirements adopted by HHS.

The newest data shows nearly ubiquitous adoption of EHRs, but also variation in the types of technology adopted by different types of physicians in different practice types. We found no significant difference across primary care, medical, and surgical specialties for both overall EHR adoption and the range of EHRs used. Market share among leading and midmarket EHR developers does not vary significantly by specialty; however, it may be that the “long tail” of non-market leading EHRs used across specialties may vary, as some smaller developers may serve specific specialties with niche technology or data needs. Future studies could examine the variation in market share across physician specialties and other physician characteristics, as market leaders for the overall outpatient market may vary from the market leaders for individual specialties or practice types. However, we do find that physician practice size and ownership are associated with overall EHR adoption rates and technology choice. Whereas 32% of physicians in solo practice reported using an EHR from one of the five market-leading developers, 90% of physicians in the largest practices (greater than 50 physicians) did so. From the smallest to the largest practice sizes, the relationship between size and technology choice is clear. This relationship may also factor in the effect of ownership on EHR adoption, as well.

Nearly all physicians in HMO, academic medical center, and hospital-owned practices reported use of an EHR from one of the top five market leading developers. Physicians in these ownership groups may also tend to practice in larger settings and likely share instances or use technology from the same developer as their parent organization. Analysis of hospital EHR adoption shows a similar relationship between hospital type (academic medical center and system-owned) and technology use.(4) Physicians that practice as part of a federally-qualified health center (FQHC) also reported high use of market-leading EHRs. The Health Resources and Services Administration (HRSA) Community Health Center Program requires use of certified health IT and, as program data shows, most FQHCs report use of certified technology from a market-leading or midmarket developer.(5) The data clearly show a relationship between practice size, ownership and technology adoption. Solo and physician-led practices have adopted EHRs at the lowest rates – with 4 in 5 reporting a certified EHR in 2024. However, fewer physicians practice this way today than ten years ago, as outpatient care has increasingly corporatized and conglomerated into larger affiliated practices.(6) These larger groups may have more resources to invest not only in the most up to date certified EHRs, but also ancillary technologies for API and network-based exchange and artificial intelligence. If EHRs are the digital foundation for ongoing technology evolution, certain physicians (and their patients) may be slower to evolve their technology to deliver 21^st Century care — important considerations for future technology policy and technology advancement.

Definitions

Electronic health record (EHR): A digital version of a patient’s paper chart. It contains health information collected and maintained by healthcare providers over time. It’s a comprehensive, longitudinal record of a patient’s health history, including diagnoses, lab results, medications, physician notes, and more, accessible to authorized healthcare professionals.

Any EHR: Any non-billing electronic system used to document patient care.

Certified EHR: An EHR that is certified to meet US Department of Health and Human Services health IT certification requirements.

Primary care specialist: Physician board-certified to a clinical focus for recurring patient care, such as family medicine, internal medicine, or pediatrics.

Medical specialist: Physician board-certified to a clinical focus on a specific branch of medicine, such as cardiology, nephrology, or oncology.

Surgical specialist: Physician board-certified to a clinical focus on diagnosing and operating on specific organ systems, such as an orthopedist, neurosurgeon, or vascular surgeon.

Health Management Organization (HMO): Type of health care organization and/or insurance plan that limits coverage to doctors, hospitals, and other providers within a defined network.

Federally Qualified Health Center (FQHC): A community-based clinic that receives federal funding to provide comprehensive, high-quality primary and preventive care to underserved, rural, or low-income populations, regardless of their ability to pay

Academic Medical Center: A hospital and affiliated outpatient sites integrated with a medical school that combines advanced patient care with research and teaching.

Data Sources and Methods

EHR adoption statistics were generated from two sources. For years 2008 and 2010, official statistics were derived from the National Ambulatory Medical Care Survey (NAMCS), and for years 2012-2024, official statistics were derived from the National Electronic Health Record Survey (NEHRS). The annual estimates for the “Any” EHR statistic were estimated using responses to the question, “Does the reporting location use an EHR system? Do not include billing record systems.” Responses of “Yes” were used to estimate these rates. The annual estimates for the “Certified” EHR statistic were estimated using responses to the question, “Is your EHR system certified to meet U.S. Department of Health and Human Services requirements?”. Responses of “Yes” were used to estimate these rates alone in 2014 and 2016. For years 2018-2024, responses to “Is your EHR system certified…” were compared to responses to the follow-up question to “Does the reporting location use…”: “What is the name of your PRIMARY EHR system?” The EHR developer response options to the question are provided in Appendix Table 2.

The ten EHR developers provided as given response options for this question are all developers of certified health IT (https://chpl.healthit.gov/). It may be that some physician respondents were unsure or not certain about the certification status of their EHR. A comparative analysis of responses to the three questions: (1) “Does the reporting location use…”, (2) “Is your EHR system certified…”, and (3) “What is the name…” shows that about 10% of respondents who say they use an EHR, don’t know if their EHR is certified or that their technology is not certified (Appendix Table 3). These rates are higher for respondents who report an “Other” EHR. To correct for probable recall or knowledge bias, for “Don’t know” and “No” responses to “Is your EHR system certified…” where the respondent selected one of the ten provided developers of certified health IT, we updated those responses to “Is your EHR system certified…” to “Yes”. We did not perform this update for responses to “Other” EHRs. Though the write-in’s are available in the restricted data file, not all respondents provided a write-in and not all write-in responses could be validated against the Certified Health IT Product List (CHPL) or other public sources, making validation inconsistent across survey years. We decided to take a conservative approach and leave those responses as reported when calculating the statistics reported in this data brief. Due to this approach, the “Certified EHR” rate may still be underestimated.

Data Availability

The National Center for Health Statistics (NCHS) administers the National EHR Survey. Survey questionnaires, documentation, and public access to the survey data can be found on the official government website: https://www.cdc.gov/nchs/nehrs/index.html.

References

1. Heisey-Grove D and Patel V. Any, Certified, or Basic: Quantifying Physician EHR Adoption. Office of the National Coordinator for Health Information Technology. Data Brief: 28. September 2015.
2. Office of the National Coordinator for Health Information Technology. Office-based Physician Electronic Health Record Adoption. Health IT Quick-Stat: 50. Available from: https://healthit.gov/data/quickstats/office-based-physician-electronic-health-record-adoption/. Accessed on: March 3, 2026.
3. DesRoches CM, Campbell EG, Rao SR, Donelan K, Ferris TG, Jha A, et al. Electronic Health Records in Ambulatory Care — A National Survey of Physicians. New England Journal of Medicine. 2008;359(1):50–60.
4. Barker W, Chang W. Hospital Electronic Health Record Adoption, 2008-2024. Office of the National Coordinator for Health Information Technology. Data Brief: 83. June 2026.
5. Health Resources & Services Administration. Electronic Reading Room. Available from: https://www.hrsa.gov/foia/electronic-reading. Accessed on: March 3, 2026.
6. Kane C. Physician Practice Characteristics in 2024: Private Practices Account for Less Than Half of Physicians in Most Specialties. American Medical Association Economic and Health Policy Research. May 2025. Available from: https://www.ama-assn.org/system/files/2024-prp-pp-characteristics.pdf. Accessed on: June 1, 2026.

Acknowledgments

The authors are with the Office of Standards, Certification, and Analysis, within the Office of the National Coordinator for Health Information Technology (ONC). The data brief was drafted under the direction of Mera Choi, Director of the Technical Strategy and Analysis Division, Vaishali Patel, Deputy Director of the Technical Strategy and Analysis Division, and Wesley Barker, Chief of the Data Analysis Branch.

Suggested Citation

Barker W. Office-based Physician Electronic Health Record Adoption, 2008-2024. Office of the National Coordinator for Health Information Technology. Data Brief: 84. June 2026.

Appendix

Appendix Table 1: Percent of physicians who responded to the 2024 National EHR Survey, by physician characteristics.

Physician characteristic	% of all physicians
Age
<50	28.0%
50–71	72.0%
Specialty
Primary Care	42.7%
Medical	37.8%
Surgical	19.5%
Group size
1 physician	20.7%
2–3 physicians	19.2%
4–10 physicians	28.8%
11–50 physicians	16.7%
51+ physicians	14.0%
Insurance
Medicare	84.1%
Medicaid	77.5%
Both	67.4%
Neither	5.8%
Ownership
Physician-led	49.7%
HMO	2.9%
FQHC	3.8%
Academic	19.9%
Other hospital	7.5%
Other health care corporation	9.0%
All others	7.2%

Appendix Table 2: Percent of physicians who reported use of an EHR, by EHR developer.

EHR Developer	Market Size	% of all physicians
Epic	Top 5	27.70%
Meditech	Top 5	11.10%
eClinicalWorks	Top 5	7.50%
athenahealth	Top 5	7.30%
Cerner	Top 5	5.50%
NextGen	Midmarket	4.10%
Practice Fusion	Midmarket	3.20%
Allscripts	Midmarket	2.70%
Modernizing Medicine	Midmarket	2.40%
Greenway	Midmarket	2.10%
Other	All others	21.50%
None	None	5%

Appendix Table 3: Percent of physicians who reported use of an EHR and reported they “Don’t Know” if the EHR meets HHS certification requirements.

EHR Developer	% Don’t Know responses
Allscripts	9.1%
athenahealth	10.3%
Cerner	12.6%
eClinicalWorks	11.9%
Epic	9.7%
Meditech	7.5%
Modernizing Medicine	9.8%
NextGen	7.9%
Practice Fusion	7.1%
Greenway	0.0%
Other	18.4%
Unknown	15.0%