Electronic health records in ambulatory care--a national survey of physicians.
BACKGROUND
Electronic health records have the potential to improve the delivery of health care services. However, in the United States, physicians have been slow to adopt such systems. This study assessed physicians' adoption of outpatient electronic health records, their satisfaction with such systems, the perceived effect of the systems on the quality of care, and the perceived barriers to adoption.


METHODS
In late 2007 and early 2008, we conducted a national survey of 2758 physicians, which represented a response rate of 62%. Using a definition for electronic health records that was based on expert consensus, we determined the proportion of physicians who were using such records in an office setting and the relationship between adoption and the characteristics of individual physicians and their practices.


RESULTS
Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.


CONCLUSIONS
Physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems. However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. physicians, who may differ from later adopters of these systems.
DesRoches
Catherine M
CM
Institute for Health Policy, Massachusetts General Hospital, Boston 02114, USA. cdesroches@partners.org
Campbell
Eric G
EG
Rao
Sowmya R
SR
Donelan
Karen
K
Ferris
Timothy G
TG
Jha
Ashish
A
Kaushal
Rainu
R
Levy
Douglas E
DE
Rosenbaum
Sara
S
Shields
Alexandra E
AE
Blumenthal
David
D
D000465:Algorithms; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003258:Consumer Behavior; D004059:Diffusion of Innovation; D005260:Female; D006123:Group Practice / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011216:Practice Management, Medical / Q000458:organization & administration; D011320:Primary Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care; D014481:United States