Health IT Research & Analysis
Quick Stats

Non-federal Acute Care Hospital Electronic Health Record Adoption

Last Updated

June 2026

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As of 2024, over 99% of U.S. non-federal acute care hospitals adopted an EHR certified by the Health IT Certification Program – over 10 times the rate from 15 years prior when fewer than 10% of hospitals reported use of a fully electronic system to document patient care.

Percent of Non-federal Acute Hospitals that Adopted an EHR, 2008-2024

ONC has tracked EHR adoption via multiple measures over time, as ‘EHR’ definitions have evolved and ONC has implemented the Health IT Certification Program.

Fully or partially electronic system

Early data collection and measurement from 2008-2012 tracked whether hospitals used fully or partially electronic systems to maintain patient medical records, indicating whether hospitals had eliminated paper record keeping. In 2008, 7% of hospitals reported they were using an electronic system to fully document patient care (“fully electronic”) with an additional 69% of hospital reporting they were using some paper chart keeping (“partially electronic”). 

Basic EHR

Additional measurement also tracked the adoption and use of computerized systems capable of documenting patient information, make orders, and view diagnostic results. The “Basic EHR” definition published in 2008 by DesRoches, et al. (https://www.nejm.org/doi/10.1056/NEJMsa0802005) identified key capabilities that represented core clinical and administrative tasks an electronic system should be able to do to be considered an “EHR”. Similar to measurement of “fully electronic systems”, in 2008 about 9% of hospitals used technology that met the “Basic EHR” definition. By 2018 – ten years later — 98% of hospitals reported the same.

Certified EHR

Finally, ONC also formally measured the percent of hospitals that adopted an EHR certified by the Health IT Certification Program. Beginning in 2012, one year after the Program issued its first certification, over 90% of hospitals reported use of a “Certified EHR”. In 2018, the percent of hospitals who reported use of a “Basic EHR” and “Certified EHR” converged at about 99%, indicating the speed at which hospitals adopted certified technology capable of electronically completing core clinical and administrative tasks. 

The different measures, taken together, show a broad and detailed picture of the rapid digitization of US hospitals, where nearly all patient care is now electronically documented, information can be shared electronically, and key diagnostic tests and results can be viewed at the point of care. 

The chart and table reflect different measures of EHR adoption over time – “Fully electronic”, “Partially electronic”, “Basic”, and “Certified”. The trends reflect distinct ways EHR adoption was measured for the given year, using the methodologies described below. 

How do we define and measure an “EHR”? 

The term “EHR” has changed in meaning over the years. In plain language, ONC defines an EHR as “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 (https://healthit.gov/health-it-basics/benefits-ehrs/).” 

But when we seek to track and measure EHR adoption over time, more specific, measurable definitions are used to compare adoption across health care providers. In 2008, DesRoches, et al. (https://www.nejm.org/doi/10.1056/NEJMsa0802005) published a methodology to assess the type of technology used by ambulatory providers, identifying key computerized capabilities that, if adopted together, constituted a spectrum of “EHRs”, ranging from “Basic” to “Comprehensive”. Beginning in 2008, the “Basic” EHR definition was used as a proxy to measure the percent of health care providers that used technology for a range of clinical tasks that enabled electronic capture of patient health information and the ability to order and view medications and diagnostics. In 2009, the HITECH Act created the Health IT Certification Program, and in its provisions required that technology certified as part of the Program would need to meet certain requirements as part of the “Qualified” EHR definition. This definition was adopted in Certification Program regulations as the “Base” EHR definition, a very similar set of capabilities as adopted as part of the “Basic” EHR definition in 2008. The qualified or base EHR definition would underpin EHR certification going forward, and so as the Program certified its first modules in late 2010, measurement, too, began to track provider adoption of “Certified” EHRs. So, as this quick stat visualizes, measurement of “EHR adoption” has evolved as statutory definitions, data collection, and technology have evolved. 

Definitions:

Fully electronic system: A medical or health record system that is fully electronic and excludes systems solely for billing. 

Partially electronic system: A medical or health record system that is partially electronic and excludes systems solely for billing. 

Basic EHR: The “Basic EHR” definition was first defined in DesRoches, et al. (200), “Electronic Health Records in Ambulatory Care — A National Survey of Physicians” (https://www.nejm.org/doi/10.1056/NEJMsa0802005). Hospitals have adopted a basic electronic health record system with clinician notes when the main site of the hospital includes a computerized system with capabilities in the following areas: patient demographics, physician notes, nursing assessments, patient problem lists, electronic lists of medications taken by patients, discharge summaries, advanced directives, orders for medications, viewing laboratory results, and viewing radiology results. 

Certified EHR: Hospitals have adopted a certified electronic health record system if the EHR technology meets the technological capability, functionality, and security requirements adopted by the Department of Health and Human Services. 

Hospitals: Non-federal acute care hospital.