Report: few doctors using EHRs.

A recent report published in The New England Journal of Medicine revealed that even though doctors who use electronic health records (EHRs) said the records have improved the quality and timeliness of care, fewer than one in five U.S. doctors is using EHRs.

According to the national survey, e-records were used in less than 9 percent of small offices with one to three doctors, where nearly half of U.S. doctors practice medicine. The report also found that EHRs were used in 51 percent of larger practices, with 50 or more doctors. Still, the adoption rate of U.S. doctors and hospitals, according to the survey of 2,600 doctors nationwide, trails most developed nations.

The survey suggests that the slow adoption rates have to do with the cost of implementing electronic records systems. However, experts said moving patient records into the electronic age is critical to improving health care, reducing errors, and containing rising costs.

According to The New York Times, insurers and hospitals can save money as a result of less paper handling, lower administration expenses, and fewer unnecessary lab tests when they are connected to EHRs in doctors' offices. Still, it is mainly doctors who must make the initial investment.

Some experts suggest that the government should provide incentives or subsidies to speed the use of computerized patient records in the United States. The government recently announced a $150 million Medicare project that will offer doctors incentives to move from paper to EHRs. The program is intended to help up to 1,200 small practices in 12 cities and states make the transition. Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of EHRs. According to the Times, more programs across the country are planned.

The study shows that large medical groups--including Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, and University of Pittsburgh Medical Center--have long been early adopters. These integrated groups have more money and can capture financial savings from EHRs by combining doctors, clinics, hospitals, and often some insurance.

The findings of the study, which was paid for by the Department of Health and Human Services and a grant from the Robert Wood Johnson Foundation, also show a strong endorsement of EHRs by doctors who use them, especially for what the report termed "fully functional" records, which include reminders of care guidelines based on a patient's age, gender, or medical history.

For example, according to the survey, 82 percent of those using EHRs said they improved the quality of clinical decisions, 86 percent said they helped prevent medication errors, and 85 percent said they improved the delivery of preventative care.

EHR Use in the U.S.

Larger medical provider groups
have been quicker to adopt electronic
health records than smaller
medical practices:

1-3 Drs.                 8.6%
4-5 Doctors             14.5%
6-10 Doctors            23.6%
11 to 50 Doctors        29.3%
More than 50 Doctors    50.5%

Source: The New York Times

Note: Table made from pie chart.